THE SECRETARY OF HEALTH AND HUMAN SERVICES 

WASHINGTON, D.C. 20201

December 10, 2009 

The Honorable Joseph R. Biden, Jr. 

President of the United States Senate 

Washington, D.C. 20510 

Dear Mr. President: 

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 42 

C.F.R. pt. 83, a petition was filed on behalf of workers from the Oak Ridge Hospital in Oak Ridge,

Tennessee, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and 

Health (NIOSH) evaluated the petition and presented its findings to the Advisory Board on Radiation 

and Worker Health (Board) on October 21, 2009. The Board considered the petition, and on November 

19, 2009, I received the Board’s recommendation concerning this petition. I have also received the 

deliberations, findings, and recommendations of the Director of NIOSH and the Director of CDC. 

Based on this information, I have designated the following class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and 

its contractors and subcontractors who worked in any location at the Oak 

Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 through 

December 31, 1959, for a number of work days aggregating at least 250 

work days or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC.

The criteria and findings upon which this designation is based are provided in the enclosed report. 

 

Please contact me if you have any further questions regarding this matter. 

Sincerely, 

[Signature on file] 

Kathleen Sebelius 

Secretary 

Enclosure 
 

 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES 

WASHINGTON, D.C. 20201

December 10, 2009 

The Honorable Harry Reid 

Majority Leader 

United States Senate 

Washington, D.C. 20510 

Dear Senator Reid: 

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 42 

C.F.R. pt. 83, a petition was filed on behalf of workers from the Oak Ridge Hospital in Oak Ridge,

Tennessee, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and 

Health (NIOSH) evaluated the petition and presented its findings to the Advisory Board on Radiation 

and Worker Health (Board) on October 21, 2009. The Board considered the petition, and on November 

19, 2009, I received the Board’s recommendation concerning this petition. I have also received the 

deliberations, findings, and recommendations of the Director of NIOSH and the Director of CDC. 

Based on this information, I have designated the following class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and 

its contractors and subcontractors who worked in any location at the Oak 

Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 through 

December 31, 1959, for a number of work days aggregating at least 250 

work days or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC.

The criteria and findings upon which this designation is based are provided in the enclosed report. 

 

Please contact me if you have any further questions regarding this matter. 

Sincerely, 

[Signature on file] 

Kathleen Sebelius 

Secretary 

Enclosure 
 

 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES 

WASHINGTON, D.C. 20201

December 10, 2009 

The Honorable Mitch McConnell 

Minority Leader 

United States Senate 

Washington, D.C. 20510 

Dear Senator McConnell: 

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 42 

C.F.R. pt. 83, a petition was filed on behalf of workers from the Oak Ridge Hospital in Oak Ridge,

Tennessee, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and 

Health (NIOSH) evaluated the petition and presented its findings to the Advisory Board on Radiation 

and Worker Health (Board) on October 21, 2009. The Board considered the petition, and on November 

19, 2009, I received the Board’s recommendation concerning this petition. I have also received the 

deliberations, findings, and recommendations of the Director of NIOSH and the Director of CDC. 

Based on this information, I have designated the following class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and 

its contractors and subcontractors who worked in any location at the Oak 

Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 through 

December 31, 1959, for a number of work days aggregating at least 250 

work days or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC.

The criteria and findings upon which this designation is based are provided in the enclosed report. 

 

Please contact me if you have any further questions regarding this matter. 

Sincerely, 

[Signature on file] 

Kathleen Sebelius 

Secretary 

Enclosure 
 

 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES 

WASHINGTON, D.C. 20201

December 10, 2009 

The Honorable Nancy Pelosi 

Speaker of the House of Representatives 

Washington, D.C. 20515 

Dear Madam Speaker:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 42 

C.F.R. pt. 83, a petition was filed on behalf of workers from the Oak Ridge Hospital in Oak Ridge,

Tennessee, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and 

Health (NIOSH) evaluated the petition and presented its findings to the Advisory Board on Radiation 

and Worker Health (Board) on October 21, 2009. The Board considered the petition, and on November 

19, 2009, I received the Board’s recommendation concerning this petition. I have also received the 

deliberations, findings, and recommendations of the Director of NIOSH and the Director of CDC. 

Based on this information, I have designated the following class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and 

its contractors and subcontractors who worked in any location at the Oak 

Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 through 

December 31, 1959, for a number of work days aggregating at least 250 

work days or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC.

The criteria and findings upon which this designation is based are provided in the enclosed report. 

 

Please contact me if you have any further questions regarding this matter. 

Sincerely, 

[Signature on file] 

Kathleen Sebelius 

Secretary 

Enclosure 
 

 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES 

WASHINGTON, D.C. 20201

December 10, 2009 

The Honorable John A. Boehner 

Minority Leader 

House of Representatives 

Washington, D.C. 20515 

Dear Congressman Boehner: 

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 42 

C.F.R. pt. 83, a petition was filed on behalf of workers from the Oak Ridge Hospital in Oak Ridge,

Tennessee, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and 

Health (NIOSH) evaluated the petition and presented its findings to the Advisory Board on Radiation 

and Worker Health (Board) on October 21, 2009. The Board considered the petition, and on November 

19, 2009, I received the Board’s recommendation concerning this petition. I have also received the 

deliberations, findings, and recommendations of the Director of NIOSH and the Director of CDC. 

Based on this information, I have designated the following class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and 

its contractors and subcontractors who worked in any location at the Oak 

Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 through 

December 31, 1959, for a number of work days aggregating at least 250 

work days or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC.

The criteria and findings upon which this designation is based are provided in the enclosed report. 

 

Please contact me if you have any further questions regarding this matter. 

Sincerely, 

[Signature on file] 

Kathleen Sebelius 

Secretary 

Enclosure 
 

HHS Designation of Additional Members of the 

Special Exposure Cohort 

under the 

Energy Employees Occupational Illness Compensation Program Act of 2000 

Designating a Class of Employees from 

Oak Ridge Hospital 

Oak Ridge, Tennessee 

HHS Special Exposure Cohort Designation: 

Oak Ridge Hospital, Oak Ridge, Tennessee
I. Designation 

I, Kathleen Sebelius, Secretary of Health and Human Services, designate the class 

of employees defined in Section II of this report for addition to the Special Exposure 

Cohort (SEC), as authorized under the Energy Employees Occupational Illness 

Compensation Program Act of 2000 (EEOICPA), 42 U.S.C. § 7384q. 

 _December 10, 2009 ___[Signature on file]_____ 

 Date Kathleen Sebelius

II. Employee Class Definition 

All employees of the Department of Energy, its predecessor agencies, and its 

contractors and subcontractors who worked in any location at the Oak Ridge 

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

1959, for a number of work days aggregating at least 250 work days or in 

combination with work days within the parameters established for one or 

more other classes of employees in the SEC. 

III. Designation Criteria and Recommendations 

Pursuant to 42 U.S.C. § 7384q, for the class defined in Section II of this report, the 

Secretary has determined, and the Advisory Board on Radiation and Worker Health 

(Board) has recommended, that 

(1) it is not feasible to estimate with sufficient accuracy the radiation dose that the 

class received; and 

(2) there is a reasonable likelihood that such radiation dose may have 

endangered the health of members of the class. 

The SEC final rule states in 42 C.F.R. § 83.13(c)(1) that it is feasible in two situations 

to estimate the radiation dose that the class received with sufficient accuracy. First, 

the rule states that radiation doses may 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 under plausible circumstances by any 

member of the class. Alternatively, radiation doses may be estimated with sufficient 

accuracy if NIOSH has established that it has access to sufficient information to 

estimate the radiation doses of members of the class more precisely than a 

maximum dose estimate. 

The Board, pursuant to 42 U.S.C. § 7384q, advised the Secretary to designate the 

class as an addition to the SEC in a letter received by the Secretary on November 

19, 2009. 

HHS Special Exposure Cohort Designation: 

Oak Ridge Hospital, Oak Ridge, Tennessee

Page 2
IV. Designation Findings 

Feasibility of Estimating Radiation Doses with Sufficient Accuracy

The Secretary established the feasibility determination for the class of employees 

covered by this report based upon the findings summarized below. 

 NIOSH determined that members of this class may have received internal and 

external radiation exposures from 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. 

 NIOSH located no internal or sufficient external monitoring data, no area 

monitoring data or sufficiently detailed process or source term information 

associated with the Oak Ridge Hospital to bound worker exposures at the Oak 

Ridge Hospital during the period from May 15, 1950 through December 31,1959. 

 NIOSH finds that it is not feasible to estimate, with sufficient accuracy, the total 

internal dose for workers who worked in any location at the Oak Ridge Hospital 

from May 15, 1950 through December 31, 1959 and NIOSH finds that it is not 

feasible to estimate, with sufficient accuracy, the total external dose for the class 

of employees covered by this evaluation, with the exception of some workers 

where limited external monitoring data may be available. NIOSH finds that it is 

feasible to estimate, with sufficient accuracy, occupational medical dose for the 

class of employees covered by this evaluation.. 

 Pursuant to 42 C.F.R. § 83.13(c)(1), NIOSH determined that there is insufficient 

information to either: (1) 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 (2) 

estimate the radiation doses of members of the class more precisely than a 

maximum dose estimate. 

 The Board concurred with the NIOSH evaluation and recommended the proposed 

class for addition to the SEC. 

 Health Endangerment

The Secretary established the health endangerment determination for the class of 

employees covered by this report based upon the findings summarized below. 

(1) Pursuant to 42 C.F.R. § 83.13(c)(3), NIOSH established that there is a 

reasonable likelihood that such radiation doses may have endangered the 

health of members of the class. Pursuant to 42 C.F.R. § 83.13(c)(3)(ii), 

NIOSH specified a minimum duration of employment to satisfy this health 

endangerment criterion as “having been employed for a number of work days 

aggregating at least 250 work days within the parameters established for this 

class or in combination with work days within the parameters (excluding 

HHS Special Exposure Cohort Designation: 

Oak Ridge Hospital, Oak Ridge, Tennessee

Page 3
HHS Special Exposure Cohort Designation: 

Oak Ridge Hospital, Oak Ridge, Tennessee

Page 4

(2) NIOSH did not identify any evidence from the petitioners or from other 

resources that would establish that the class was exposed to radiation during 

a discrete incident likely to have involved exceptionally high-level exposures, 

such as a nuclear criticality incident, as defined under 42 C.F.R. § 

83.13(c)(3)(i). 

(3) The Board concurred with NIOSH’s finding that the health of the class may 

have been endangered and defined the class according to the 250-work day 

requirement specified under 42 C.F.R. § 83.13(c)(3)(ii). 

V. Effect and Effective Date of Designation 

The Secretary submits this report on the designation of one additional class to the 

SEC for review by Congress, pursuant to 42 U.S.C. §§ 7384l(14)(C)(ii) and 

7384q(c)(2)(A), as amended by the Ronald W. Reagan National Defense 

Authorization Act for Fiscal Year 2005, Pub. L. No. 108-375 (codified as amended in 

scattered sections of 42 U.S.C.). Pursuant to 42 U.S.C. § 7384l(14)(C)(ii), as 

amended by the Ronald W. Reagan National Defense Authorization Act for Fiscal 

Year 2005, Pub. L. No. 108-375 (codified as amended in scattered sections of 42 

U.S.C.), the designation in this report will become effective 30 days after the date of 

this report’s submission to Congress “unless Congress otherwise provides.” 

VI. Administrative Review of Designation 

The health endangerment determination of the designation provided in this report 

may be subject to an administrative review within HHS, pursuant to 42 C.F.R. § 

83.18(a). On the basis of such a review, if the Secretary decides to expand the class 

of employees covered by this designation, the Secretary would transmit a 

supplementary report to Congress providing the expanded employee class definition 

and the criteria and findings on which the decision was based.