ORAU TEAM

Dose Reconstruction

Project for NIOSH

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

Page 1 of 25

Document Title:

Atomics International – Occupational 

Medical Dose

Document Number: ORAUT-TKBS-0038-3 

Revision: 01 

Effective Date: 09/08/2006

Type of Document: TBD

Supersedes: Revision 00

Subject Expert: Robert L. Morris

Document Owner

Approval: Signature on File Approval Date: 08/17/2006

Melton H. Chew, TBD Team Leader

Approval: Richard Merrill Signature on File for Approval Date: 08/17/2006

John M. Byrne, Task 3 Manager

Concurrence: Signature on File Concurrence Date: 08/18/2006

Edward F. Maher, Task 5 Manager

Concurrence: Signature on File Concurrence Date: 08/17/2006

Kate Kimpan, Project Director

Approval: Brant Ulsh Signature on File for Approval Date: 09/08/2006

James W. Neton, Associate Director for Science

 New Total Rewrite Revision Page Change

FOR DOCUMENTS MARKED AS A TOTAL REWRITE, REVISION, OR PAGE CHANGE, REPLACE THE PRIOR 

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION.
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 2 of 25

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION 

NUMBER DESCRIPTION

02/03/2006 00 New technical basis document for the Energy Technical Center -

Occupational Medical Dose. First approved issue. Initiated by 

Melton H. Chew.

09/08/2006 01 Revision to change the site name to Atomics International throughout 

the document in keeping with DOE site naming conventions. 

Updated required language in Section 3.1. Purpose section (Section 

3.2) and Scope section (Section 3.3) were added. Approved 

Revision 01. No further changes occurred as a result of formal 

internal review. Incorporates NIOSH formal review comments. 

Training required: As determined by the Task Manager. Initiated by 

Melton H. Chew.
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 3 of 25

TABLE OF CONTENTS

SECTION TITLE

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

PAGE

5

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

3.2 Purpose ...................................................................................................................................7

3.3 Scope.......................................................................................................................................7

3.4 Examination Frequency ...........................................................................................................8

 3.4.1 Pre-employment Examination........................................................................................8

 3.4.1.1 Prior to 1971....................................................................................................8

 3.4.1.2 1972 Through 1997 .........................................................................................9

 3.4.1.3 After 1997........................................................................................................9

 3.4.2 Routine Examination .....................................................................................................9

 3.4.2.1 Prior to 1971....................................................................................................9

 3.4.2.2 1971 Through 1997 ....................................................................................... 10

 3.4.2.3 After 1997...................................................................................................... 10

3.5 Equipment and Techniques.................................................................................................... 10

 3.5.1 Prior to 1971................................................................................................................10

 3.5.1.1 Chest Views .................................................................................................. 10

 3.5.1.2 Lumbar-Spine Views...................................................................................... 10

 3.5.2 1971 Through 1997.....................................................................................................11

 3.5.2.1 Chest Views................................................................................................... 11

 3.5.2.2 Lumbar-spine Views ...................................................................................... 11

 3.5.3 After 1997 ...................................................................................................................12

 3.5.3.1 Chest Views .................................................................................................. 12

 3.5.3.2 Lumbar-Spine Views...................................................................................... 12

3.6 Organ Dose Calculations ....................................................................................................... 12

 3.6.1 Basis and Methodology ...............................................................................................12

3.7 Dose Reconstruction..............................................................................................................14

3.8 Uncertainty.............................................................................................................................14

References ........................................................................................................................................24

Glossary ............................................................................................................................................25
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LIST OF TABLES

TABLE TITLE

3-1 Analogues for IREP organs not included in ICRP Publication 34 (ICRP 1982).......................

PAGE

13

3-2 Summary of parameters and organ doses for 14- by 17-in. PA chest 

radiography............................................................................................................................16

3-3 Summary of parameters and organ doses for 14- by 17-in. LAT chest 

radiography............................................................................................................................17

3-4 Summary of parameters and organ doses for a single exposure AP lumbarspine radiograph ....................................................................................................................18

3-5 Summary of parameters and organ doses for a single exposure LAT lumbarspine radiograph ....................................................................................................................19

3-6 Maximum organ doses in rem for 14- by 17-in. PA chest radiography.................................... 20

3-7 Maximum organ doses in rem for LAT chest radiography....................................................... 21

3-8 Maximum organ doses in rem for single exposure AP lumbar-spine

radiography............................................................................................................................22

3-9 Maximum organ doses in rem for single exposure LAT lumbar-spine

radiography ............................................................................................................................23
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ACRONYMS AND ABBREVIATIONS

AP anterior-posterior

AI Atomics International

cGy centigray

cm centimeter

DCF dose conversion factor

DOE U.S. Department of Energy

EEOICPA Energy Employees Occupational Illness Compensation Program Act

ESE entrance skin exposure

ETEC Energy Technology Center

FDA Food and Drug Administration

Gy gray

ICRP International Commission on Radiological Protection

in. inch

IREP Interactive RadioEpidemiological Program

keV kiloelectron-volt (1,000 electron-volts)

kVp kilovolts-peak

LAT lateral

mA milliampere

mGy milligray

mm millimeter

mR milliroentgen

NIOSH National Institute for Occupational Safety and Health

PA posterior-anterior

R roentgen

sec second

SID source-to-image distance

SSD source-to-skin distance

U.S.C. United States Code

yr year
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3.1 INTRODUCTION

Technical basis documents and site profile documents are not official determinations made by the 

National Institute for Occupational Safety and Health (NIOSH) but are rather general working 

documents that provide historic background information and guidance to assist in 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 NIOSH staff in the completion of the individual work required for each dose 

reconstruction.

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

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

employer facility” or a “Department of Energy [DOE] facility” as defined in the Energy Employees 

Occupational Illness Compensation Program Act [EEOICPA; 42 U.S.C. § 7384l(5) and (12)]. 

EEOICPA defines a DOE facility as “any building, structure, or premise, including the grounds upon 

which such building, structure, or premise is located ... in which operations are, or have been, 

conducted by, or on behalf of, the Department of Energy (except for buildings, structures, premises, 

grounds, or operations ... pertaining to the Naval Nuclear Propulsion Program)” [42 U.S.C. § 

7384l(12)]. Accordingly, except for the exclusion for the Naval Nuclear Propulsion Program noted 

above, any facility that performs or performed DOE operations of any nature whatsoever is a DOE 

facility encompassed by EEOICPA.

For employees of DOE or its contractors with cancer, the DOE facility definition only determines 

eligibility for a dose reconstruction, which is a prerequisite to a compensation decision (except for 

members of the Special Exposure Cohort). The compensation decision for cancer claimants is based 

on a section of the statute entitled “Exposure in the Performance of Duty.” That provision [42 U.S.C. § 

7384n(b)] says that an individual with cancer “shall be determined to have sustained that cancer in the 

performance of duty for purposes of the compensation program if, and only if, the cancer ... was at 

least as likely as not related to employment at the facility [where the employee worked], as 

determined in accordance with the POC [probability of causation1

As noted above, the statute includes a definition of a DOE facility that excludes “buildings, structures, 

premises, grounds, or operations covered by Executive Order No. 12344, dated February 1, 1982 (42 

U.S.C. 7158 note), pertaining to the Naval Nuclear Propulsion Program” [42 U.S.C. § 7384l(12)]. 

While this definition contains an exclusion with respect to the Naval Nuclear Propulsion Program, the 

section of EEOICPA that deals with the compensation decision for covered employees with cancer 

[i.e., 42 U.S.C. § 7384n(b), entitled “Exposure in the Performance of Duty”] does not contain such an 

exclusion. Therefore, the statute requires NIOSH to include all occupationally derived radiation 

exposures at covered facilities in its dose reconstructions for employees at DOE facilities, including 

radiation exposures related to the Naval Nuclear Propulsion Program. As a result, all internal and 

external dosimetry monitoring results are considered valid for use in dose reconstruction. No efforts 

are made to determine the eligibility of any fraction of total measured exposure for inclusion in dose 

reconstruction. NIOSH, however, does not consider the following exposures to be occupationally 

derived:

] guidelines established under 

subsection (c) ...” [42 U.S.C. § 7384n(b)]. Neither the statute nor the probability of causation 

guidelines (nor the dose reconstruction regulation) define “performance of duty” for DOE employees 

with a covered cancer or restrict the “duty” to nuclear weapons work.

 

1 The U.S. Department of Labor is ultimately responsible under the EEOICPA for determining the POC. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 7 of 25

• Radiation from naturally occurring radon present in conventional structures

• Radiation from diagnostic X-rays received in the treatment of work-related injuries

3.2 PURPOSE

The purpose of this document is to provide a technical basis for evaluation of the occupational 

medical dose for EEOICPA claimants who were employed at the Atomics International (AI) facility 

described below. 

3.3 SCOPE

The scope of this document is technical data regarding medical X-rays provided to workers as a 

condition of employment. 

The facility, which includes four locations, has been identified in various ways over time. The name 

Atomics International (AI) is used to represent all of them unless more specific location information is 

warranted. In that context, AI includes Area IV of the Santa Susana Field Laboratory which has also 

been known as Nuclear Development Field Laboratory, Liquid Metal Engineering Center, and Energy 

Technology Engineering Center (ETEC), portions of the Downey facility, the Vanowen Building at the 

Canoga facility and the De Soto facility. 

U.S. Atomic Energy Commission-funded work at the AI facility began in 1948. North American 

Aviation (NAA) entered into a contract with AEC to conduct nuclear research operations at Area IV 

and the Downey, Canoga and De Soto sites. At that time, Atomics International, an internal division 

of NAA, was the company’s designated nuclear research and development division. In addition to the 

employees of the AI division, other employees of NAA who worked at any of the above sites during 

the AEC contract period are potentially eligible for EEOICPA benefits. AI clinicians prescribed chest 

X-ray examinations, and in some cases lumbar-spine X-ray examinations. These examinations 

caused exposure of the lungs and other tissues of the body. Exposure came from the primary X-ray 

beam and from scattered and leakage radiation. 

A review of randomly selected X-ray films dating back to 1956 provided insight into the occupational 

medical program (Morris 2005a). Individual AI medical charts do not contain X-ray films. If an old film 

is to be reviewed, the separate X-ray record must be retrieved. Three boxes of archived radiographs

representing approximately 300 individuals were reviewed. The boxes contained an envelope for 

each individual; each envelope contained films spanning many years for that person. The outside of 

each file storage envelope describes the contents, so it is possible to determine easily the number 

and kind of radiograph and if the radiograph represents a preemployment examination, periodic 

reexamination, or a workup following an industrial injury. Radiographs associated with an industrial 

injury are often identified as “IND”; they are not pertinent to dose reconstruction. Due to corporate 

reorganizations, the medical records of employees of the AI division of NAA are intermingled with 

records of another of NAA’s internal divisions, Rocketdyne. Employees of Rocketdyne (or any other 

employee of NAA) are potentially within the scope of EEOICPA if they worked at Area IV or the 

Downey, Canoga, or De Soto locations during the period when the AEC contract work was performed. 

In a few cases, a file was annotated “AI” indicating that the person was an Atomics International 

employee, but in the majority of cases the employment status is not clear. The review of records 

suggests that:

• About half of the pre-employment examinations included both posterior-anterior (PA) and 

lateral (LAT) chest views and one or two views (PA and LAT) of the lumbar spine. The 

remainder included only one PA chest view.
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• It was rare for an employee to have annual chest radiographs. Most individuals were never 

subjected to periodic radiographic reexamination.

• Of those who were reexamined, the typical periodic examination frequency was every 3 to 

5 years. About half of those reexamined had one PA chest view. Others had a PA chest and 

some form of lumbar-spine examination.

• There was no evidence of collimation on the radiographs.

• There was no evidence suggesting the use of photofluorography.

• There was no evidence suggesting the use of fluoroscopy.

• There was no evidence suggesting the use of stereo chest films (same view on two films, 

slightly displaced).

• All typical views – PA chest, LAT chest, AP lumbar spine, and LAT lumbar spine – commonly 

found in the records were of the same size: 14 in. by 17 in.

• In a few cases, AP spot and LAT spot lumbar-spine views were observed, and in these cases 

a smaller film size, 10 in. by 12 in., was common.

• There was no evidence of the use of gonadal shielding in the lumbar-spine views.

Interviews with medical clinic personnel provided information on the equipment and techniques used 

between 1971 and 1997. By 1998, all radiographic examinations were subcontracted to West Hills 

Hospital in West Hills, California. 

Neutron exposures were not used in occupational medical evaluations and are not part of the 

occupational medical dose. Similarly, there is no electron dose in the occupational medical dose.

3.4 EXAMINATION FREQUENCY 

Existing programmatic documents do not furnish a complete record of the criteria used since 1948 to 

determine which workers were required to have X-ray examinations or the frequencies of the 

examinations; nevertheless, some information is available. More importantly, the claimant records 

provided by DOE are likely to provide information on the radiographs administered to the claimant. 

This is discussed in section 3.5. Consequently the assumptions provided in this section should be 

used only for screening or when the claimant record proves to be inadequate. 

This summary is based on inspection of records and discussions with current and former staff 

members of the AI clinic and health physics department. 

3.4.1

3.4.1.1 Prior to 1971

Pre -employment Examination

Radiation safety standards dating back to 1966 (Garcia and Alexander 1970) required “pre-exposure 

examinations” for radiation workers. This examination was to include a chest X-ray. It is reasonable

and favorable to the claimant to assume that this practice has been in effect for radiation workers 
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since the origination of AI. For dose reconstruction this should be interpreted as a pre-employment 

physical requirement.

Some AI employees who were not radiation workers would not have been covered by this standard. 

Therefore, some employees might not have received routine preemployment radiographic 

examinations. A review of AI X-ray film historical records (Morris 2005b) indicated that some 

employees had preemployment chest and lumbar-spine radiographic examinations. Criteria for the 

selection of these employees have not been found. 

Lacking specific information in a claimant record, a reasonable science-based assumption that gives 

the benefit of the doubt to claimants is that all employees had a pre-employment examination 

consisting of: 

• PA chest film,

• LAT chest film,

• AP lumbar spine film

• AP lumbar spine spot film. 

3.4.1.2 1972 Through 1997

In an interview, the nurse who took many of the radiographs beginning in 1971 stated that 

preemployment physicals were routinely required of all AI personnel (Chew 2005). Such physicals 

included a PA chest radiograph. Lumbar-spine radiographs were sometimes required, depending on 

the job description. No photofluorography was performed. This or a similar examination policy was 

probably in place prior to 1966 and continued well into the 1990s. Lacking specific information in a 

claimant record, a reasonable science-based assumption that gives the benefit of the doubt to 

claimants is that all employees had a pre-employment examination consisting of: 

• PA chest film,

• LAT chest film,

• AP lumbar spine film

• AP lumbar spine spot film. 

3.4.1.3 After 1997

An interview with the current medical director found that the policy on chest X-rays was in place when 

he assumed his position in 1995 (Morris 2005a). By 1997, he was actively discouraging chest X-rays. 

Preemployment lumbar-spine and chest radiography has not occurred as a condition of employment 

since 1997.

3.4.2

3.4.2.1 Prior to 1971

Routine Examination

Radiation safety standards dating back to 1966 (Garcia and Alexander 1970) required periodic 

examinations at a minimum frequency of 1 yr for radiation workers. The standards also required 

termination examinations. The periodic examination included a chest X-ray. The standard does not 

require lumber spine examination. This or a similar examination policy was probably in place prior to 

1966 and continued well into the 1990s. Lacking specific claimant information, assume each radiation 

worker had a PA and LAT radiographic chest examination every year and one AP lumbar spine with 

an AP lumbar spine spot film examination every four years. 
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For personnel who were not radiation workers, no information is available regarding the periodic 

radiographic examination schedule. A review of AI X-ray film historical records (Morris 2005b) 

suggests that some workers did undergo periodic surveillance. No clear frequency pattern was 

discernable, but annual examinations were rare. Among those receiving routine surveillance, three to 

five years (and often more) elapsed between radiographic examinations. Lacking specific claimant 

information assume each person who was not a radiation worker had one PA and LAT radiographic 

chest examination every three years and one AP lumbar spine with an AP lumbar spine spot film

examination every three years.

3.4.2.2 1971 Through 1997

The examination frequency and assumptions described for years prior to 1971 applies for the period 

1971 through 1997.

3.4.2.3 After 1997

An interview with the current medical director found that the policy on chest X-rays was in place when 

he assumed his position in 1995 (Morris 2005a). By 1997, he was actively discouraging routine chest 

X-rays. Routine lumbar-spine and chest radiography has not occurred as a condition of employment 

since 1997.

Tables 3-2 through 3-5 include information on the routine frequency of chest radiography for periods 

throughout the AI operating history.

3.5 EQUIPMENT AND TECHNIQUES

3.5.1

No specific information is available on diagnostic X-ray equipment and techniques used at AI prior to 

1971. An interview with the current AI physician (Morris 2005a), who is familiar with the content of the 

historical medical files, and an inspection of randomly selected radiographs from this period (Morris 

2005b) revealed no evidence that photofluorography, fluoroscopy, or stereo radiography was used at 

AI. 

Prior to 1971

3.5.1.1 Ches t Views

The pre-1971 parameters for PA and LAT chest techniques are assumed values based on data for 

the “Pre-1970 Period” in Table 3-4 of ORAU (2005). The TBD analysis assumed that the entrance 

kerma for the PA view is 0.20 cGy. For the LAT view, it assumed the entrance kerma is 0.50 cGy.

3.5.1.2 Lumbar-Spine Views

The pre-1971 default values for AP and LAT lumbar-spine views are assumed based on data for the 

technique described in Tables 7-7 through 7-10 of ORAU (2005). Table 7-7 lists the anterior-posterior 

(AP) and AP spot view techniques as 80 kVp, 2.0 mm of Al filtration, 40 mA, for 4 sec at a source-toimage distance (SID) of 99 cm with a 20-cm cone. Two AP views are assumed, the AP and the AP 

spot. Table 7-7 lists LAT and LAT spot view techniques as 86 kVp, 2.0 mm of Al filtration, 40 mA, for

8 sec at SID of 99 cm with a 20-cm cone. Two LAT views are assumed, the LAT and the LAT spot. 

Table 7-8 from ORAU (2005) defines the entrance skin exposure (ESE) for both AP lumbar-spine

views combined as 4.0 rem. The unit rem is typically assumed for dosimetry purposes to be 

numerically the same as the unit cGy, so the ESE is interpreted to be 4 cGy. The ESE for both LAT
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 11 of 25

lumbar-spine views combined is 10 rem (10 cGy). If it can be shown that only one AP or LAT lumbarspine view was made, it is reasonable to assume the values can be divided by 2. Table 7-10 in 

ORAU (2005) lists measured or calculated organ doses that are acceptable default values for pairs of 

early lumbar-spine exposures.

3.5.2

An interview with the nurse/technician who operated the X-ray machine revealed that prior to or during 

1971 a Picker X-ray system, Model 754971, was installed in the AI clinic (Chew 2005). The reported 

maximum settings on the unit were 125 kVp and 600 mA. The machine filtration is not known so, 

consistent with the recommendation of ORAU (2005) for machines prior to 1980, this TBD analysis

assumed it to be 2.5 mm Al. The equipment was used for PA chest and lumbar-spine projections. 

The normal technique for chest X-rays was to use 80- to 90-kVp tube potential and 1/60 second 

exposure time, resulting in a collimated exposure of 200 mAs at a standard SID of 72 in. The routine 

practice of the clinic was to use lead aprons on patients as practicable and to provide gonadal 

shielding, in the form of a lead cup, to male patients.

1971 Through 1997

This TBD analysis assumed that the reported value of 200 mAs, is unreasonably high, and is wrong. 

If the Picker X-ray machine delivered a 200 mAs exposure to a contemporary X-ray film and cassette 

assembly, the resulting film would be overexposed and of marginal value (perhaps no value) as a 

diagnostic tool. The reviewing physician would have required the technique be changed to a lower 

exposure. For chest exams PA views, a value closer to 10 mAs is more likely (CRCPD 1994) and 20 

mAs is a high estimate. Therefore the value of 20 mAs is assumed. ORAU (2005) suggests a 

conservative estimate for the ESE for the LAT view of 2.5 times the PA ESE. Using this estimate, the 

analysis assumed the exposure for the LAT view is 50 mAs. This TBD assumes these values for 

calculation of ESE and organ dose for chest X-rays. 

Photofluorography was not performed in the AI clinic during this period because the Picker system 

was not capable of that technique.

3.5.2.1 Ches t Views

For simplicity, this TBD assumes the performance of all chest radiographs at 90 kVp because this 

produces a higher average air kerma rate than 80 kVp and is, therefore, favorable to claimants. 

Based on Table B.3 in NCRP (1989), a single-phase machine with an SID of 183 cm (72 in.) operating 

at 90 kVp produces an average air kerma rate of 0.18 cGy/100 mAs. For a 20-mAs exposure in the 

AP view, this equates to average air kerma of 0.036 cGy. For 50 mAs in the LAT view, this equates to 

an average air kerma of 0.09 cGy. Correcting for a source to skin distance (SSD) of 154 cm, the 

entrance kerma (numerically the same as the ESE) is 0.050 cGy for the PA view and 0.130 cGy for 

the LAT view. These ESE values are used to calculate organ doses, as discussed in Section 3.1 of 

ORAU (2005).

3.5.2.2 Lumbar-s pine Views

No specific information is available on the lumbar-spine technique used at AI in this period; the default 

data in ORAU (2005) for lumbar-spine views is derived from 1953 data and unlikely to reflect the 

practice two decades later. The lumbar-spine technique was probably a modern one, similar to that

described in 1995 by the Conference of Radiation Control Program Directors (CRCPD 2001). As a 

consequence, this analysis assumes the technique to be 78 kVp, 294 mAs, HVL of 3.1 mm Al, with an 

average ESE of 0.370 cGy.
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3.5.3

In 1997, the Picker system was retired and radiographic examinations were performed on a 

subcontract basis at West Hills Hospital. That arrangement continues today. Considering the wide 

assortment of X-ray equipment at a modern medical center such as West Hills, it is not possible to 

identify the specific equipment and techniques that were used. However, it is reasonable to assume 

the use of modern well-maintained equipment for exposures. This TBD assumes that the ESE is 

comparable to the default values for modern equipment specified in Table 3-4 of ORAU (2005). It 

also assumes that filtration is equivalent to 4.0 mm Al, which is the default value for beam quality after

1980.

After 1997

3.5.3.1 Ches t Views

This TBD bases its assumption of the post-1997 default values for PA and LAT chest on data for the 

“Post-1985 Period” in Table 3-4 of ORAU (2005). It assumed that the entrance kerma for the PA view 

is 0.05 cGy. For the LAT view, it assumed the entrance kerma is 0.13 cGy.

3.5.3.2 Lumbar-Spine Views

No specific information is available on the lumbar-spine technique used at AI during this period; the 

default data in ORAU (2005) for lumbar-spine views is derived from 1953 data and unlikely to reflect 

the practice two decades later. The lumbar-spine technique was probably a modern one, similar to 

that described in 1995 by the Conference of Radiation Control Program Directors (CRCPD 2001). As 

a consequence, the TBD analysis assumed that the technique is 78 kVp, 294 mAs, with an average 

ESE of 0.370 cGy.

3.6 ORGAN DOSE CALCULATIONS

3.6.1

With the exception of measured values taken from tables, and dose to the skin, estimates of the mean 

dose equivalents to individual organs from a given X-ray exposure are the product of the ESE and a 

dose conversion factor (DCF) from ICRP (1982). Skin doses are calculated as the product of ESE 

and a backscatter factor from Table B.8 in NCRP (1989). The backscatter factor varies by field size 

and filtration. ORAU (2005) recommends a backscatter factor of 1.35 for chest films made using a 

machine with 2.5 mm of Al filtration. For chest films made using a machine with 4.0 mm of Al

filtration, ORAU (2005) recommends a backscatter factor of 1.40. The skin dose calculated in ORAU

(2005) for the default evaluation of early lumbar-spine techniques uses a backscatter factor of 1.32. 

More recent equipment used in lumbar spine examinations is likely to be more highly filtered and a 

backscatter factor of 1.35 is more appropriate.

Bas is and Methodology

For chest views and lumbar-spine views of differing beam quality, ICRP (1982) contains tables of 

DCFs for as many as seven organs and the total (whole) body based on an adult anthropomorphic 

phantom. For an organ not listed in these tables, but needed for the Interactive RadioEpidemiological 

Program (IREP), the DCF is that for the anatomically closest organ in the ICRP tables. Table 3-1 lists 

ICRP reference organs for IREP analogs (ORAU 2005). ICRP (1982) lists different DCFs for males 

and females for the lung, bone marrow, and total (whole) body. The larger of the two values is 

assigned for the dose equivalent to the IREP organ analogs. 

The ICRP tables were developed under the assumption that the primary X-ray beam is collimated to 

the image receptor size, which is reasonable subsequent to 1971. Earlier techniques were probably 
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not well collimated. Because no information regarding the collimation practices prior to 1971 was 

discovered, the application of these DCF tables to the early X-ray machines must occur in a way that 

compensates for the possible lack of collimation. ORAU (2005) assessed allowance for this 

circumstance during different periods in the past based on ICRP (1982). 

The ICRP DCFs give the average dose equivalent in a given organ in milligray for different beam 

qualities when the entrance kerma (air kerma in air without backscatter) is 1 Gy. ORAU (2005) 

approximated that an ESE of 1 R produces a skin entrance kerma of 1 rad. In addition to simplifying 

Table 3-1. Analogs for IREP organs not included in ICRP (1982).

Anatomical 

location 

ICRP (1982) 

reference organ IREP organ analog

Thorax Lung Thymus 

Esophagus 

Stomach 

Bone surface

Liver/gall bladder/spleen

Remainder organs 

Abdomen Ovaries Urinary/bladder 

Colon/rectum 

Head and neck Thyroid Eye/brain 

the computations, this assumption is well within relatively large uncertainties from other sources and 

is favorable to claimants. 

This TBD analysis used the following guidelines to develop Tables 3-2 through 3-9. 

When an organ-dose equivalent difference between male and female organs exists, both are listed in 

Tables 3-2 through 3-5. The larger of the two is listed in Tables 3-6 through 3-9.

ICRP (1982) does not tabulate dose conversion factors for lumbar-spine views for the female breast, 

but the table includes the comment “Not computed but small compared to the projections listed 

above.” The smallest DCF in those tabulated projections is 9 mGy/Gy for beams filtered with 2.5 mm 

Al and 21 mGy/Gy for beams filtered with 4.0 mm Al. A DCF approximately 50% of the smallest 

tabulated value for each beam quality is assumed. A DCF of 5 mGy/Gy is used for beams filtered 

with 2.5 mm Al and a DCF of 10 mGy/Gy is used for beams filtered with 4.0 mm Al. This assumption 

can be validated by comparing the assumed DCFs to those tabulated in ICRP (1982) for the 

approximately inverse exposure condition: dose to the ovary delivered by a chest X-ray. For both 

filtrations the value is 5.2 mGy/Gy or less. For years prior to 1971 the selection of an appropriate 

DCF is not at issue as the breast dose is taken from measured values in Table 7-10 of ORAU (2005). 

Default assumptions in ORAU (2005) are used unless specific data or documented assumptions to 

the contrary are cited. If specific claimant files indicate the use of photofluorography, dose 

reconstructors should apply the default parameters and organ dose factors values in ORAU (2005). 

Table 3-2 is a summary of parameters and organ doses for 14-in. by 17-in. PA chest radiography for 

periods during which each X-ray system was in use. Table 3-3 is a summary of parameters and 

organ doses for LAT chest radiography. For the period prior to 1971 organ doses are taken from 

ORAU (2005) Table 6-5, with the exception of Whole Body, which is calculated as the product of ESE 

and an appropriate DCF from ICRP (1982). For periods subsequent to 1971 the doses are calculated 

as the product of ESE and a DCF from ICRP (1982). Lung dose is used as a surrogate for remainder 

organ dose. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 14 of 25

Tables 3-4 and 3-5 summarize parameters and organ doses for AP and LAT lumbar-spine

radiography, respectively. Lumbar-spine films are sometimes done in pairs: a large 14-in. by 17-in. 

radiograph and a smaller spot film of the same view. If the claimant medical records indicate the use 

of both a large format and spot film of the same view, dose reconstructors should double the doses in 

Tables 3-4 and 3-5 to represent the dose for that pair of exposures. For the period prior to 1971 

organ doses are taken from ORAU (2005) Table 7-10, with the exception of Whole Body dose, which 

is calculated as the product of ESE and an appropriate DCF from ICRP (1982). For periods 

subsequent to 1971 the doses are calculated as the product of ESE and a DCF from ICRP (1982). 

Lung dose is used as a surrogate for remainder organ dose. 

Tables 3-6 through 3-9 list doses for the thyroid, ovaries, maximum other organ (excluding skin), and 

maximum remainder organ for each year, beginning in 1948 and ending in 2003. 

Tables 3-6 and 3-7 list PA and LAT chest radiography doses, respectively. In Table 3-6 and 3-7 the 

“maximum additional organ” represents the highest organ dose, excluding skin, not otherwise shown 

in that table. This may be the breast dose or lung dose depending on the view and technique. The 

“maximum remainder” organ dose is referenced to the lung dose as specified in Table 3-1. 

Tables 3-8 and 3-9 list AP and LAT lumbar-spine radiography doses, respectively. In Table 3-8 and 3-

9 the “maximum additional organ” represents the highest organ dose, excluding skin, not otherwise 

shown in that table. The uterus is the highest dose organ in the AP view. In the LAT view, the 

abdominal IREP organs (urinary tract, bladder, colon and rectum) share this designation. The 

“maximum remainder” organ dose is referenced to the lung dose as specified in Table 3-1. 

3.7 DOSE RECONSTRUCTION

The records provided by DOE are likely to include adequate information to define the date, type, and 

count of X-ray examinations that were administered to the claimant as a condition of employment. 

Use the assumptions regarding radiographic exposure frequency only for screening or when specific 

claimant records are not available. 

If confusion about the radiographic exposure record exists, consider requesting that the notes on the 

exterior of the envelope(s) containing the claimant’s X-ray films be transcribed and provided. These 

notes should give insight to the reason that the exposures were made, for example pre-employment 

examination, routine surveillance, or diagnosis of injury. Assume that any radiograph that was not

Depending on equipment and technique, the photon energy associated with occupational medical 

X-ray dose is in either the less-than-30-keV energy group or the 30-to-250-keV energy group. 

Assignment of all AI occupational medical doses to the 30-to-250-keV energy group is favorable to 

claimants and recommended. 

 a 

PA chest, LAT chest, AP lumbar spine, or LAT lumbar spine view was diagnostic, not to be included in 

dose reconstruction. If the X-ray envelop notes associate the annotation “IND” or “industrial” with a 

particular exposure, that means the radiograph was a diagnostic exposure (i.e., associated with a 

workplace injury). “IND” radiographs are not included in dose reconstruction. 

3.8 UNCERTAINTY

ORAU (2005) analyzed uncertainties in the required occupational medical X-ray organ doses. The 

document considered several major sources of uncertainty: measurement errors; variations in applied 

voltage (peak voltage), beam current and exposure time; and uncertainties due to patient size and 

placement. ORAU (2005) assesses the relative error in an individual ESE or organ dose to be ±30% 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 15 of 25

at 1 standard deviation. The actual doses could have been as much as 30% larger than those listed

in Tables 3-2 through 3-9.
Document No. ORAUT-TKBS-0038-3 Revision No. 

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Table 3-2. Parameters and organ doses for 14-in. by 17-in. PA chest radiography. 

Period Frequency Applicability

PA chest 

ESE (mR)

Organ dose (rem)

Thyroida Ovariesa Testesa Lungsa Breasta 

Uterus 

(embryo)a 

Bone 

marrowa Skinb,c WBa Remaindere

Pre-1971 Entrance: likely

Routine annual: likely

Exit: likely

All radiation 

workers

200 3.48E-02 

(d)

2.5E-02

(d)

5.0E-03

(d)

Male:

8.38E-02

Female:

9.02E-02

(d)

9.80E-03

(d)

2.5E-02

(d)

Male:

1.84E-02

Female:

1.72E-02

(d)

2.70E-01

(d)

Male:

2.62E-02

Female:

2.36E-02

9.02E-02 (d)

Pre-1971 Entrance: likely

Routine assumed to be at 

3-yr intervals

Exit: not likely

Non-radiation 

workers

200 3.48E-02 

(d)

2.5E-02

(d)

5.0E-03

(d)

Male:

8.38E-02

Female:

9.02E-02

(d)

9.80E-03

(d)

2.5E-02

(d)

Male:

1.84E-02

Female:

1.72E-02

(d)

2.70E-01

(d)

Male:

2.62E-02

Female:

2.36E-02

9.02E-02 (d)

1971 to 

1997

Entrance: likely

Routine annual: likely

Exit: likely

All radiation 

workers

50 1.60E-03 5.00E-05 5.00E-07 Male:

2.10E-02

Female:

2.26E-02

2.45E-03 6.50E-05 Male:

4.60E-03

Female:

4.30E-03

6.75E-02 Male:

6.55E-03

Female:

5.90E-03

2.26E-02

1971 to 

1997

Entrance: likely

Routine: assumed to be 

at 3-yr intervals 

Exit: not likely

Non-radiation 

workers

50 1.60E-03 5.00E-05 5.00E-07 Male:

2.10E-02

Female:

2.26E-02

2.45E-03 6.50E-05 Male:

4.60E-03

Female:

4.30E-03

6.75E-02 Male:

6.55E-03

Female:

5.90E-03

2.26E-02

1998 to 

present

Highly unlikely All workers 50 3.90E-03 2.60E-04 5.00E-07 Male:

3.14E-02

Female:

3.37E-02

5.80E-03 2.60E-04 Male:

8.90E-03

Female:

8.60E-03

7.00E-02 Male:

9.60E-03

Female:

8.90E-03

3.37E-02

a. Organs identified in ICRP (1982) for dose determination from ESE associated with chest radiography.

b. Skin dose for X-ray machines with filtration equivalent to 2.5 mm Al are calculated using a backscatter factor of 1.35 as recommended in ORAU (2005). This is the assumed filtration for machines used 

prior to 1998.

c. Skin dose for X-ray machines with filtration equivalent to 4.0 mm Al are calculated using a backscatter factor of 1.40 as recommended in ORAU (2005). This is the assumed filtration for machines used 

after 1997.

d. From ORAU (2005) Table 6-5 column labeled “Organ dose pre-1970 (rem) minimal collimation”. 

e. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 

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Table 3-3. Parameters and organ doses for 14-in. by 17-in. LAT chest radiography. 

Period Frequency Applicability

LAT 

chest 

ESE (mR)

Organ doses (rem)

Thyroida Ovariesa Testesa Lungsa Breasta 

Uterus 

(embryo)a 

Bone 

marrowa Skinb,c WBa Remaindere 

Pre-1971 Entrance: likely

Routine annual: likely

Exit: likely

All radiation 

workers

500 6.85E-02 

(d)

1.3E-02

(d)

2.5E-03

(d)

Male:

9.65E-02

Female:

1.10E-01

(d)

1.28E-01

(d)

1.3E-02

(d)

Male:

1.85E-02

Female:

1.45E-02

(d)

6.75E-01

(d)

Male:

3.00E-02

Female:

3.20E-02

1.10E-01 (d)

Pre-1971 Entrance: likely

Routine assumed to be at 

3-yr intervals

Exit: not likely

Non-radiation 

workers

500 6.85E-02 

(d)

1.3E-02

(d)

2.5E-03

(d)

Male:

9.65E-02

Female:

1.10E-01

(d)

1.28E-01

(d)

1.3E-02

(d)

Male:

1.85E-02

Female:

1.45E-02

(d)

6.75E-01

(d)

Male:

3.00E-02

Female:

3.20E-02

1.10E-01 (d)

1971 to 

1997

Entrance: likely

Routine annual: likely

Exit: likely

All radiation 

workers

130 1.50E-02 7.80E-05 1.30E-05 Male:

2.51E-02

Female:

2.86E-02

3.32E-02 7.80E-05 Male:

4.81E-03

Female:

3.77E-03

1.76E-01 Male:

7.80E-03

Female:

8.32E-03

2.86E-02

1971 to 

1997

Entrance: likely

Routine: assumed to be 

at 3-yr intervals 

Exit: not likely

Non-radiation 

workers

130 1.50E-02 7.80E-05 1.30E-05 Male:

2.51E-02

Female:

2.86E-02

3.32E-02 7.80E-05 Male:

4.81E-03

Female:

3.77E-03

1.76E-01 Male:

7.80E-03

Female:

8.32E-03

2.86E-02

1998 to 

present

Highly unlikely All workers 130 2.13E-02 3.25E-04 1.30E-05 Male:

4.07E-02

Female:

4.56E-02

4.46E-02 2.73E-04 Male:

9.88E-03

Female:

7.67E-03

1.82E-01 Male:

1.38E-02

Female:

1.29E-02

4.56E-02

a. Organs identified in ICRP (1982) for dose determination from ESE associated with chest radiography. 

b. Skin dose for X-ray machines with filtration equivalent to 2.5 mm Al are calculated using a backscatter factor of 1.35 as recommended in ORAU (2005). This is the assumed filtration for machines used 

prior to 1998.

c. Skin dose for X-ray machines with filtration equivalent to 4.0 mm Al are calculated using a backscatter factor of 1.40 as recommended in ORAU (2005). This is the assumed filtration for machines used 

after 1997.

d. From ORAU (2005) Table 6-5 column labeled “Organ dose pre-1970 (rem) minimal collimation.” 

e. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 

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Table 3-4. Parameters and organ doses for a single-exposure AP lumbar-spine radiograph. 

Period Frequency Applicability

AP 

lumbarspine

ESE (mR)

Organ doses (rem) from 14-in. by 17-in. AP lumbar-spine or spot AP lumbar-spine radiography

Thyroida Ovariesa Testesa Lungsa Breasta 

Uterus 

(embryo)a 

Bone 

marrowa Skinb,c WBa Remainderf

Pre-1971d Entrance: likely

Routine annual: assumed 

to be at 3-yr intervals

Exit: not likely

All workers 2,000e 4.00E-04 5.60E-01 2.70E-02 1.24E-01 3.60E-02 4.34E+00 4.80E-02 2.64E+00 1.66E-01 1.24E-01

1971 to 

1997

Entrance: likely

Routine annual: assumed 

to be at 3-yr intervals

Exit: not likely

All workers 370 1.11E-04 7.99E-02 1.55E-03 2.92E-02 1.85E-03 1.06E-01 1.37E-02 5.00E-01 3.77E-02 2.92E-02

1998 to 

presente 

Highly unlikely All workers 370 4.81E-04 1.43E-01 4.07E-03 4.55E-02 3.7E-03 1.78E-01 3.44E-02 5.18E-01 5.62E-02 4.55E-02

a. Organs identified in ICRP (1982) for dose determination from ESE associated with lumbar-spine radiography.

b. Skin dose for X-ray machines with filtration equivalent to 2.5 mm Al are calculated using a backscatter factor of 1.35 as recommended in ORAU (2005). This is the assumed filtration for machines used 

prior to 1998.

c. Skin dose for X-ray machines with filtration equivalent to 4.0 mm Al are calculated using a backscatter factor of 1.40 as recommended in ORAU (2005). This is the assumed filtration for machines used 

after 1997. 

d. Organ doses for Pre-1971 period are derived from ORAU (2005, Table 3-2). 

e. ESE and organ doses are presented for a single AP or spot SP lumbar-spine view. If both AP and spot AP lumbar-spine views were imaged, double the ESE and organ doses in this row. 

f. Lung is the reference organ for “Remainder”, see Table 3-1.
Document No. ORAUT-TKBS-0038-3 Revision No. 

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Table 3-5. Parameters and organ doses for a single-exposure LAT lumbar-spine radiograph. 

Period Frequency Applicability

LAT 

lumbarspine

ESE 

(mR)

Organ doses (rem) from 14- by 17-in. LAT lumbar-spine or Spot LAT lumbar-spine radiography

Thyroida Ovariesa Testesa Lungsa Breasta 

Uterus 

(Embryo)a 

Bone 

marrowa Skinb,c WBa Remainderf 

Pre-1971d Entrance: likely

Routine annual: assumed 

to be at 3-yr intervals

Exit: not likely

All workers 5,000e 5.00E-05 7.60E-01 5.6E-02 5.00E-02 4.75E-02 1.00E-01 7.50E-02 6.60E+00 1.90E-01 5.00E-02 

1971 to 

1997

Entrance: likely

Routine annual: assumed 

to be at 3-yr intervals

Exit: not likely

All workers 370 3.70E-06 1.74E-02 2.96E-04 5.18E-03 1.85E-03 1.15E-02 8.14E-03 5.00E-01 1.59E-02 5.18E-03

1998 to 

presente 

Highly unlikely All workers 370 3.70E-06 4.07E-02 9.62E-04 9.62E-03 3.70E-03 2.89E-02 2.04E-02 5.18E-01 2.44E-02 9.62E-03

a. Organs identified in ICRP (1982) for dose determination from ESE associated with lumbar-spine radiography.

b. Skin dose for X-ray machines with filtration equivalent to 2.5 mm Al are calculated using a backscatter factor of 1.35 as recommended in ORAU (2005). This is the assumed filtration for machines used 

prior to 1998.

c. Skin dose for X-ray machines with filtration equivalent to 4.0 mm Al are calculated using a backscatter factor of 1.40 as recommended in ORAU (2005). This is the assumed filtration for machines used 

after 1997. 

d. Organ doses for Pre-1971 period are derived from ORAU (2005, Table 3-2). 

e. ESE and organ doses are listed for a single LAT or Spot LAT lumbar-spine view. If both LAT and Spot LAT lumbar-spine views were imaged, double the ESE and organ doses in this row. 

f. Lung is the reference organ for “Remainder”, see Table 3-1.
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 20 of 25

Table 3-6. Maximum organ doses (rem) for 14-in. by 

17-in. PA chest radiography. 

Year

Maximum 

thyroid

Maximum 

ovaries

Maximum 

additional organsa

Maximum 

remainderb 

1948 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1949 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1950 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1951 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1952 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1953 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1954 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1955 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1956 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1957 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1958 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1959 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1960 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1961 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1962 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1963 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1964 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1965 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1966 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1967 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1968 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1969 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1970 3.48E-02 2.5 E-02 9.02E-02 9.02E-02

1971 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1972 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1973 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1974 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1975 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1976 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1977 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1978 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1979 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1980 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1981 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1982 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1983 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1984 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1985 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1986 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1987 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1988 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1989 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1990 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1991 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1992 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1993 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1994 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1995 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1996 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1997 1.60E-03 5.00E-05 2.26E-02 2.26E-02

1998 3.90E-03 2.60E-04 3.37E-02 3.37E-02

1999 3.90E-03 2.60E-04 3.37E-02 3.37E-02

2000 3.90E-03 2.60E-04 3.37E-02 3.37E-02

2001 3.90E-03 2.60E-04 3.37E-02 3.37E-02

2002 3.90E-03 2.60E-04 3.37E-02 3.37E-02

2003 3.90E-03 2.60E-04 3.37E-02 3.37E-02

a. Not including skin. 

b. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 21 of 25

Table 3-7. Maximum organ doses (rem) for LAT chest 

radiography. 

Year

Maximum 

thyroid

Maximum 

ovaries

Maximum 

additional organsa

Maximum 

remaindera,b

1948 6.85E-02 1.3 E-02 1.10E-01 1.10E-01 

1949 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1950 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1951 6.85E-02 1.3 E-02 1.28E-01 1.10E-01 

1952 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1953 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1954 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1955 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1956 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1957 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1958 6.85E-02 1.3 E-02 1.28E-01 1.10E-01 

1959 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1960 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1961 6.85E-02 1.3 E-02 1.28E-01 1.10E-01 

1962 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1963 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1964 6.85E-02 1.3 E-02 1.28E-01 1.10E-01 

1965 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1966 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1967 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1968 6.85E-02 1.3 E-02 1.28E-01 1.10E-01 

1969 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1970 6.85E-02 1.3 E-02 1.28E-01 1.10E-01

1971 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1972 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1973 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1974 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1975 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1976 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1977 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1978 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1979 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1980 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1981 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1982 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1983 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1984 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1985 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1986 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1987 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1988 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1989 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1990 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1991 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1992 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1993 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1994 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1995 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1996 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1997 1.50E-02 7.80E-05 3.32E-02 2.86E-02

1998 2.13E-02 3.25E-04 4.56E-02 4.56E-02

1999 2.13E-02 3.25E-04 4.56E-02 4.56E-02

2000 2.13E-02 3.25E-04 4.56E-02 4.56E-02

2001 2.13E-02 3.25E-04 4.56E-02 4.56E-02

2002 2.13E-02 3.25E-04 4.56E-02 4.56E-02

2003 2.13E-02 3.25E-04 4.56E-02 4.56E-02

a. Not including skin. 

b. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 22 of 25

Table 3-8. Maximum organ doses (rem) for singleexposure AP lumbar-spine radiography. 

Year

Maximum 

thyroida 

Maximum 

ovariesa 

Maximum 

additional 

organsa,b,c

Maximum 

remaindera,b,d

1948 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1949 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1950 4.00E-04 5.60E-01 4.34E+01 1.24E-01 

1951 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1952 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1953 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1954 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1955 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1956 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1957 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1958 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1959 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1960 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1961 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1962 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1963 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1964 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1965 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1966 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1967 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1968 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1969 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1970 4.00E-04 5.60E-01 4.34E+01 1.24E-01

1971 1.11E-04 7.99E-02 1.06E01 2.92E-02

1972 1.11E-04 7.99E-02 1.06E01 2.92E-02

1973 1.11E-04 7.99E-02 1.06E01 2.92E-02

1974 1.11E-04 7.99E-02 1.06E01 2.92E-02

1975 1.11E-04 7.99E-02 1.06E01 2.92E-02

1976 1.11E-04 7.99E-02 1.06E01 2.92E-02

1977 1.11E-04 7.99E-02 1.06E01 2.92E-02

1978 1.11E-04 7.99E-02 1.06E01 2.92E-02

1979 1.11E-04 7.99E-02 1.06E01 2.92E-02

1980 1.11E-04 7.99E-02 1.06E01 2.92E-02

1981 1.11E-04 7.99E-02 1.06E01 2.92E-02

1982 1.11E-04 7.99E-02 1.06E01 2.92E-02

1983 1.11E-04 7.99E-02 1.06E01 2.92E-02

1984 1.11E-04 7.99E-02 1.06E01 2.92E-02

1985 1.11E-04 7.99E-02 1.06E01 2.92E-02

1986 1.11E-04 7.99E-02 1.06E01 2.92E-02

1987 1.11E-04 7.99E-02 1.06E01 2.92E-02

1988 1.11E-04 7.99E-02 1.06E01 2.92E-02

1989 1.11E-04 7.99E-02 1.06E01 2.92E-02

1990 1.11E-04 7.99E-02 1.06E01 2.92E-02

1991 1.11E-04 7.99E-02 1.06E01 2.92E-02

1992 1.11E-04 7.99E-02 1.06E01 2.92E-02

1993 1.11E-04 7.99E-02 1.06E01 2.92E-02

1994 1.11E-04 7.99E-02 1.06E01 2.92E-02

1995 1.11E-04 7.99E-02 1.06E01 2.92E-02

1996 1.11E-04 7.99E-02 1.06E01 2.92E-02

1997 1.11E-04 7.99E-02 1.06E01 2.92E-02

1998 4.81E-04 1.43E-01 1.78E-01 4.55E-02

1999 4.81E-04 1.43E-01 1.78E-01 4.55E-02

2000 4.81E-04 1.43E-01 1.78E-01 4.55E-02

2001 4.81E-04 1.43E-01 1.78E-01 4.55E-02

2002 4.81E-04 1.43E-01 1.78E-01 4.55E-02

2003 4.81E-04 1.43E-01 1.78E-01 4.55E-02

a. Double this value if both an AP lumbar-spine and Spot AP lumbar-spine exposure 

were made.

b. Not including skin. 

c. Representing the dose to the uterus. 

d. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 23 of 25

Table 3-9. Maximum organ doses (rem) for singleexposure LAT lumbar-spine radiography. 

Year

Maximum 

thyroida 

Maximum 

ovariesa

Maximum 

additional 

organsa,b,c

Maximum 

remaindera,b,d 

1948 5.00E-05 7.60E-01 7.60E-01 5.00E-02 

1949 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1950 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1951 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1952 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1953 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1954 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1955 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1956 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1957 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1958 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1959 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1960 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1961 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1962 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1963 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1964 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1965 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1966 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1967 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1968 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1969 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1970 5.00E-05 7.60E-01 7.60E-01 5.00E-02

1971 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1972 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1973 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1974 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1975 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1976 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1977 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1978 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1979 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1980 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1981 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1982 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1983 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1984 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1985 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1986 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1987 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1988 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1989 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1990 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1991 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1992 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1993 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1994 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1995 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1996 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1997 3.70E-06 1.74E-02 1.74E-02 5.18E-03

1998 3.70E-06 4.07E-02 4.07E-02 9.62E-03

1999 3.70E-06 4.07E-02 4.07E-02 9.62E-03

2000 3.70E-06 4.07E-02 4.07E-02 9.62E-03

2001 3.70E-06 4.07E-02 4.07E-02 9.62E-03

2002 3.70E-06 4.07E-02 4.07E-02 9.62E-03

2003 3.70E-06 4.07E-02 4.07E-02 9.62E-03

a. Double this value if both an LAT lumbar-spine and Spot LAT lumbar-spine exposure

were made.

b. Not including skin. 

c. Calculated from product of ESE times DCF for ovary to represent colon, rectum, 

urinary tract, or bladder. 

d. Lung is the reference organ for “Remainder”, see Table 3-1. 
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 24 of 25

REFERENCES

Chew, M. H., 2005, Documented Communication, “ETEC X-ray Equipment and Technique,” 

November 1.

CRCPD (Conference of Radiation Control Program Directors), 1994, “Nationwide Evaluation of X-ray 

Trends (NEXT), 1994, P/A Chest X-Ray Data,” 

www.crcpd.org/Pubs/NextTrifolds/NEXT94C_T.pdf. 

CRCPD (Conference of Radiation Control Program Directors), 2001, “Nationwide Evaluation of X-ray 

Trends (NEXT), 1995, Abdomen and LS Spine X-Ray Data,” revised May 16, 

www.crcpd.org/pubs/NextTrifolds/NEXT95Ab&LSspine.pdf. 

Garcia, R.R. and R. E. Alexander, 1970, Radiation Safety Standard Analysis – Medical Examinations 

for Radiation Workers, REA-RSSA-12, prepared December 8, 1966, revised by F. M Staszeski 

December 8, 1970.

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

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

Morris, R. L., 2005a, Documented Communication, “ETEC Occupational Medical Exposures:

Interview with Dr. Craig Conlon, ETEC Medical Director,” December 1.

Morris, R. L., 2005b, Summary of review of a sample of ETEC archive X-ray films, December 1.

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

Beam and Gamma-Ray Protection for Energies up to 50 MeV, Report No. 102, Bethesda, 

Maryland.

ORAU (Oak Ridge Associated Universities), 2005, Dose Reconstruction from Occupationally Related 

Diagnostic X-Ray Procedures, ORAUT-OTIB-0006, Rev. 03, Oak Ridge, Tennessee, 

August 2.
Document No. ORAUT-TKBS-0038-3 Revision No. 01 Effective Date: 09/08/2006 Page 25 of 25

GLOSSARY

absorbed dose

Energy absorbed per unit mass; units are rad and gray.

backscatter

Radiation scattered backwards, enhancing skin dose in areas where an X-ray beam enters the 

body.

dose equivalent

Product of absorbed dose and a quality factor or radiation weighting factor. With absorbed 

dose in rad, unit is rem.

exposure

Amount of electric charge produced per unit mass of air by electromagnetic radiation.

gray (Gy)

Unit of absorbed dose, defined as 1 joule per kilogram. It is equal to 100 rad.

kerma

Sum of initial kinetic energies of all charged particles (including Auger electrons) liberated by 

uncharged radiation per unit mass. Units are rad and gray. The word derives from the phrase 

Kinetic Energy Released in Matter. 

lumbar spine

The vertebrae of the lower back.

rad

Unit of absorbed dose, defined as 100 ergs per gram. It is equal to 0.01 Gy.

rem

Unit of dose equivalent.

roentgen

Unit of exposure, abbreviated as R.

X-ray

(1) Electromagnetic radiation emitted by fast electrons slowing down in matter or in certain 

electronic transitions in atoms. (2) A radiograph produced by X-rays.