March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

NIOSH Investigation into INL Site Profile Review

Issue 24 

Author – Jodi Jenkins

Revision 0

March 6, 2014
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

ISSUE 24

Issue 24 states the following actions for NIOSH/SC&A: Look at interviews appearing in 

SC&A’s site profile review for relevant anecdotal discussions on extremity exposures. NIOSH 

will report how many INL/ANL-W claimants have extremity cancers. 

The table below illustrates the extremity cancers for claimants at INL/ANL-W. Fifty three

claimants were diagnosed with a total of 62 cancers. The total number of claims for the INL and 

ANL-W is 1736. Three percent of INL and ANL-W claims involve extremity cancers.

NIOSH

Claim ID Facility

ICD-9

Code

Illness

Description

Diagnosis

Date Job Title

Extremity

Dosimetry

[Redacted] Idaho National 

Laboratory 172.7

Malignant Melanoma 

of the left Foot, 

Clark's Level IV

1998 [Redacted] N

[Redacted] Idaho National 

Laboratory 232.6 Cancer in situ, right leg 1993 [Redacted] N

[Redacted] Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma, in situ, 

right arm lesion

2002 [Redacted] N

[Redacted]

Idaho National 

Laboratory 232.6 SCC, in situ, left wrist 2002

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in-situ, right 

posterior forearm 2000

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC in situ-3rd digit 

on left hand 2001

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC in-situ, left 

hand

2004

[Redacted] Y

1988, 

1989

[Redacted]

Idaho National 

Laboratory 232.6 SCC in-situ, left hand 2005

[Redacted] Y

1988, 

1989

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in situ left 

elbow 2003

[Redacted]

N
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

NIOSH

Claim ID Facility

ICD-9

Code

Illness

Description

Diagnosis

Date Job Title

Extremity

Dosimetry

[Redacted]

Idaho National 

Laboratory 232.7

Squamous cell 

carcinoma in situ, left 

leg 2003

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6 SCC in-situ, left arm 2001

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.7

Squamous cell 

carcinoma, in-situ, 

right posterior ankle 2008

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.6

Malignant melanoma, 

left forearm 2005

[Redacted]

N

[Redacted]

Argonne 

National 

LaboratoryWest 232.6SCC, in-situ, left 

forearm 2011

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Melanoma, lower left 

arm in situ 2002

[Redacted]

N

[Redacted]

Argonne 

National 

LaboratoryWest 232.7Malignant melanoma 

in situ; right calf 1998

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in situ, 

lower right arm 2004

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, right index 

finger (in-situ) 2004

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, Bowen type, 

right forearm 2009

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, skin left lower 

arm, in-situ 2005

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Lentigo malignant 

melanoma, in-situ, left 

forearm 2007

[Redacted] Y 

1955-1992

[Redacted]

Idaho National 

Laboratory 172.6

Malignant melanomaleft dorsal arm 1991

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC in situ; skin, R 

hand 2003

[Redacted]

N
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

NIOSH

Claim ID Facility

ICD-9

Code

Illness

Description

Diagnosis

Date Job Title

Extremity

Dosimetry

[Redacted]

Idaho National 

Laboratory 232.6

Carcinoma in situ, 

Skin of left arm 1989

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in-situ, Bowen's 

type right middle 

finger 2005

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.7

Melanoma of the right 

leg 1951

[Redacted]

N

[Redacted]

Argonne 

National 

LaboratoryWest 232.6

Squamous cell 

carcinoma in situ; 

right arm 2002

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in situ; 

right arm 2002

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Skin; SCC in situ, 

right forearm 2004

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Melanoma in situ, left 

wrist 2005

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Malignant melanoma 

in situ, right dorsal 

hand 2005

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6 SCC, left wrist 2004

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in situ; left 

dorsal hand 1997

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Melanoma in situ -

left arm 1990

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.7

Squamous cell 

carcinoma in-situ, 

right anterior tibia 1996

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Skin cancer R middle 

finger Bowen's SCC 1989

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in-situ of 

the right wrist 2006

[Redacted]

N
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

NIOSH

Claim ID Facility

ICD-9

Code

Illness

Description

Diagnosis

Date Job Title

Extremity

Dosimetry

[Redacted]

Idaho National 

Laboratory 172.7

Acral melanoma, right 

foot 2003

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in situ, right 

dorsal hand 2012

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.7

Squamous cell 

carcinoma in-situ on 

the left lateral foot 2008

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.6

Malignant Melanoma, 

Skin, Left Arm 2003

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, Bowen's in situ, 

left forearm 2001

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma in situ of 

the left hand 2002

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

In Situ Malignant 

Melanoma 2002

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma insitu/right hand 2009

[Redacted]

N

[Redacted]

Idaho National 

Laboratory

173.7

Intraepithelial 

squamous cell 

carcinoma of the left 

ankle

2009

[Redacted]

N

55[Redacted]

Idaho National 

Laboratory 232.6

SCC, in situ, left 

forearm (Bowen's 

disease) 2011

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous Cell 

Carcinoma (SCC), in 

situ of the right 

forearm 2005

No data 

entered N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in situ, of the 

skin of the left hand 

(thenar eminence) 1998

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in situ, 

(Bowen's Disease) of 

the skin of the left 

thenar eminence 2002

[Redacted]

N
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

NIOSH

Claim ID Facility

ICD-9

Code

Illness

Description

Diagnosis

Date Job Title

Extremity

Dosimetry

[Redacted]

Idaho National 

Laboratory 232.6

SCC, in situ, right 

dorsum hand 2008

No data 

entered N

[Redacted]

Idaho National 

Laboratory 172.6

Melanoma in-situ of 

right elbow skin 2011

[Redacted]

N

[Redacted]

Argonne 

National 

LaboratoryWest 172.6Melanoma, in situ, 

right elbow 2000

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.7

Melanoma of the right 

shin 2008

[Redacted] Y 

1986-1988

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma (SCC), in 

situ, right dorsal wrist 2006

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 173.71 BCC, right lower leg 2005

[Redacted] Y 

2006-2011

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma (SCC) insitu right dorsal hand 2007

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.6

Malignant melanoma 

right lateral arm 2012

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 173.71 BCC right shin 2011

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 232.6

Squamous cell 

carcinoma (SCC) in 

situ right elbow 2006

[Redacted]

N

[Redacted]

Idaho National 

Laboratory 172.7

Melanoma left lateral 

calf 2008

No data 

entered N

[Redacted]

Idaho National 

Laboratory 232.7

Squamous cell 

carcinoma in situ 

medial left lower leg 2009

[Redacted]

N
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

The following ICD-9 codes were used in the database query:

ICD-9 

Code Description

172.6 Malig melanoma arm

172.7 Malig melanoma leg

173.70

Unspecified malig neo skin lower limb, incl 

hip

173.71 BCC skin lower limb, incl hip

173.72 SCC skin lower limb, incl hip

173.79

Other specified malig neo skin lower limb, 

incl hip

232.6 Ca in situ skin arm

232.7 Ca in situ skin leg

For codes 172.6, 172.7, 232.6 and 232.7, cancers with specified locations that did not meet the 

definition of extremity (arm below the elbow and leg below the knee) were excluded.

The following comments regarding extremity exposures are from interviews appearing in 

SC&A’s site profile review:

Multiple badges and extremity dosimetry have been in use since 1953. Multiple badges included

dosimetry for extremities (e.g., finger rings), the upper trunk, the lower trunk, and any other

location deemed necessary by RadCon personnel. “Routine” badges were worn in addition to

the multiple dosimeters provided for a job. Workers wore their primary dosimeters customarily

on their chest or at their belt level. In the case of multiple dosimeters, the highest dosimeter

value was recorded as the dose of record. The results from all badges of a multiple pack were

maintained in the individual’s dosimetry file. The use of multiple badging was based on multiple

high-level sources being present simultaneously in the work area, high-level point source with

multiple workers, or other arrangements reflecting non-uniform fields.
March 6, 2014, Rev 0

This is a working document prepared by NIOSH or its contractor for use in discussions with the ABRWH or its 

Working Groups or Subcommittees. Draft, preliminary, interim, and White Paper documents are not final NIOSH 

or ABRWH (or their technical support and review contractors) positions unless specifically marked as such. This 

document represents preliminary positions taken on technical issues prepared by NIOSH or its contractor. 

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 USC §552a and has been cleared for distribution.

 

Formal procedures are now in place for extremity and multiple badging, including when and how

to use multi-badging. The multi-badging records were kept in the regular worker files. The

highest dose recorded was assigned as the dose of record up until 1995. At that time, INL

implemented weighting factors to calculate dose from multiple dosimetry systems.

There were situations, especially during maintenance activities, where there was partial-body

exposure to workers. Many site experts were concerned about the potential in their jobs for

extremity or nonuniform exposure. Multi-badging was used only in unusual conditions. For

example, it was used during the SL-1 incident to monitor for high beta exposures. It was also

sometimes used at the NWCF. 

Multi-badging was rarely used among maintenance and operations workers. While typically 

there was some shielding afforded to the whole body during maintenance jobs, workers were 

often required to reach inside an area or around a pipe or valve where dose rates were much 

higher. In some cases, work was performed in tight spaces in close proximity to high-radiation 

sources. In the past, management required workers to perform some high radiation jobs without 

multi-badging. The multi-badging is very important in assessing external dose, as some jobs 

involved different dose rates at different body levels in a high radiation area.

Prior to the 1980 time period, extremity and multi-badging were rare. Laboratory personnel

often wore extremity monitoring. The jobs which typically required extremity dosimetry

included the following:

• Bottling of Krypton gas

• Maintenance at the NWCF

• Replacement of valve boxes in tank storage

• Entry into hot cells (starting in the 1990s)

Extremity dosimetry was implemented in the 1980s for crafts personnel. Not all operators were

provided with extremity dosimetry in the earlier years.