Document Number:

OCAS-PER-009

 

Office of Compensation Analysis and Support 

Effective Date: 

Program Evaluation Report 03/8/2007

Revision No. 0 

Target organs for lymphoma Page 1 of 2 

Author: Signature on file 

 Date: 03/08/2007 

 David Allen, Dose Reconstruction Team Leader 

Approval: Signature on file 

Supersedes: 

 J.W. Neton, Associate Director for Science 

 Date: 03/08/2007

None 

ISSUE 

AUTHORIZATION 

DATE 

EFFECTIVE

DATE 

REV. 

NO. DESCRIPTION 

3/8/2007 3/8/2007 0 New document to change target organs 

for lymphoma. 

1.0 Description

In February, 2006, OCAS determined that the internal and external dosimetry target 

organs used for several forms of lymphoma should be changed. The detailed rationale 

for this decision is described in OCAS-TIB-012. The change resulted from a detailed 

investigation by OCAS of the etiology of lymphoma. 

2.0 Evaluation

The issuance of OCAS-TIB-012 changed the internal target organ for most forms of nonHodgkin’s lymphoma and some other forms of lymphoma (primarily in the 200 – 202 ICD 

series) from the highest non-metabolic organ (HNMO) or remainder to the thoracic 

lymph nodes (LN(TH)). The calculated internal doses in these cases are almost 

invariably higher, resulting in a higher probability of causation. 

In addition, the external target organ was changed from bone marrow to various other 

organs (stomach, spleen, thyroid, lung, bladder, etc.), for most forms of lymphoma, as 

described in OCAS-TIB-012. Because the organ-specific dose conversion factors 

(DCFs) are lower for red bone marrow than for most other organs, this change also 

results in an increase in organ dose, and the resulting probability of causation. 
3.0 Resolution/Corrective Action

Guidance on target organ selection for lymphoma is given in two documents: (1) OCASTIB-012, and (2) ORAUT-OTIB-005. OCAS-TIB-012 Rev. 0 was issued on August 15, 

2005. Subsequent to issuance of that revision, further changes were made to the 

lymphoma target organs, and these changes were reflected in Rev. 1, issued on 

February 10, 2006. At the same time, ORAUT-OTIB-005 Rev. 2 PC-1 was issued to 

reflect the target organ selection as directed by OCAS-TIB-012 Rev. 1. All lymphoma 

dose reconstructions completed after approximately February 10, 2006 use the current 

target organ selections. 

A query of the NOCTS database was conducted to identify previously completed 

lymphoma claims with a probability of causation <50% which could be affected by this 

change. That query identified 528 such claims. Since the process was expected to take 

several months to complete, a Program Evaluation Plan was issued on 12/8/2006 to 

describe the issue and the plan to evaluate the individual claims. This plan required 

each of the 528 claims to be re-evaluated using the dose reconstruction methods current 

at the time of the re-evaluation. 

4.0 Conclusion

This report is issued indicating a resolution to each of the 528 claims re-evaluated. Of 

the 528 claims, 23 had been returned to NIOSH for rework for various reasons. These 

claims were updated using the current dose reconstruction methods so no evaluation 

under this PER was necessary. Five claims have no current method of dose 

reconstruction. NIOSH will ask that these claims be returned for rework based on the 

revision to the lymphoma target organ. Of the remaining 500 claims, 152 claims were 

found to now result in a probability of causation of greater than 50% while the remaining 

348 claims resulted in the probability of causation remaining below 50%. 

5.0 References

1) National Institute for Occupational Safety and Health, Office of Compensation 

Analysis and Support, External Dose Reconstruction Implementation Guideline, 

OCAS-TIB-012, Rev 1, (February, 10, 2006). 

2) ORAU Team, Technical Information Bulletin: IMBA Organ, External Dosimetry 

Organ, and IREP Model Selection by ICD-9 Code, ORAUT-OTIB-0005 Rev 02 

PC-1 (02/10/2006).