Page 1 of 29

DOE Review Release 01/19/2023

Los Alamos National Laboratory – 

Occupational Medical Dose

ORAUT-TKBS-0010-3 Rev. 02

Effective Date: 01/10/2023

Supersedes: Revision 01

Subject Expert(s): JoAnn M. Jenkins

Document Owner 

Approval: Signature on File

Victoria G. Brown, Document Owner

Approval Date: 01/06/2023

Concurrence: Signature on File

John M. Byrne, Objective 1 Manager

Concurrence Date: 01/06/2023

Concurrence: Signature on File

Scott R. Siebert, Objective 3 Manager

Concurrence Date: 01/08/2023

Concurrence: Vickie S. Short Signature on File for

Kate Kimpan, Project Director

Concurrence Date: 01/06/2023

Approval: Signature on File

Timothy D. Taulbee, Associate Director for Science

Approval Date: 01/10/2023

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

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION.

New Total Rewrite Revision Page Change
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 2 of 29

 

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION

NUMBER DESCRIPTION

12/29/2004 00 Technical basis document for the Los Alamos National Laboratory –

Occupational Medical Dose. Incorporates comments from internal 

and NIOSH reviews. First approved issue. Initiated by Jack E. 

Buddenbaum.

09/14/2010 01 Revised to incorporate data captured since the last revision to better 

document what has come to be known about PFG at LANL, and to 

add skin doses for all projections and periods. Added references and 

included Attributions and Annotations Section. Incorporates formal 

internal and NIOSH review comments. Constitutes a total rewrite of 

the document. Training required: As determined by the Objective 

Manager. Initiated by Donald N. Stewart.

01/10/2023 02 Revised to remove X-ray doses and to reference ORAUT-OTIB-0006 

in their place. Site-specific X-ray doses recalculated. Recalculated 

uncertainty using 24-cm torso thickness. This revision results in a 

change in the assigned doses. Incorporates formal internal and 

NIOSH review comments. Constitutes a total rewrite of the 

document. Initiated by John M. Byrne and authored by JoAnn M. 

Jenkins.
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 3 of 29

 

TABLE OF CONTENTS

SECTION TITLE PAGE

Acronyms and Abbreviations ............................................................................................................... 4

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

3.1.1 Purpose........................................................................................................................ 7

3.1.2 Scope........................................................................................................................... 7

3.1.3 Special Exposure Cohort.............................................................................................. 7

3.2 Examination Frequencies......................................................................................................... 8

3.3 Equipment and Techniques.................................................................................................... 10

3.4 Organ Doses.......................................................................................................................... 13

3.4.1 Dose Reconstruction Guidance .................................................................................. 21

3.4.1.1 Maximizing Approach................................................................................... 21

3.4.1.2 Best-Estimate Approach............................................................................... 21

3.5 Uncertainty............................................................................................................................. 22

References ........................................................................................................................................ 23

Glossary ............................................................................................................................................ 27

LIST OF TABLES

TABLE TITLE PAGE

3-1 Default frequency of occupational chest X-rays........................................................................ 9

3-2 X-ray equipment.....................................................................................................................11

3-3 Technique factors used for each type of X-ray equipment...................................................... 11

3-4 HVLs used to determine DCFs for dose calculations.............................................................. 12

3-5 Organ dose equivalents for chest projections, all periods....................................................... 15

3-6 Skin dose guidance for chest projections, all periods ............................................................. 16

3-7 Skin dose from chest projections, 1943 to present ................................................................. 17

3-8 IREP dose distributions and statistical parameters for the dose to the B-lymphocytes ........... 21
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 4 of 29

ACRONYMS AND ABBREVIATIONS

AWE atomic weapons employer

cGy centigray

cm centimeter

DCF dose conversion factor

DOE U.S. Department of Energy

DOL U.S. Department of Labor

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 2000

ENSD entrance skin dose

ERDA U.S. Energy Research and Development Administration

EXSD exit skin dose

Gy gray

HVL half-value layer

ICRP International Commission on Radiological Protection

in. inch

IREP Interactive RadioEpidemiological Program

keV kiloelectron-volt, 1,000 electron volts

kVp kilovolts-peak

LANL Los Alamos National Laboratory

LASL Los Alamos Scientific Laboratory

LAT lateral

m meter

mA milliampere

mAs milliampere-second

mGy milligray

mm millimeter

mrem millirem

NCRP National Council on Radiation Protection and Measurements

NIOSH National Institute for Occupational Safety and Health

ORAU Oak Ridge Associated Universities

ORAUT ORAU Team

PA posterior-anterior

PFG photofluorograph

RaLa radioactive lanthanum

RSD remote skin dose

s second

SEC Special Exposure Cohort

SSD source-to-skin distance
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 5 of 29

SRDB Ref ID Site Research Database Reference Identification (number)

TA technical area

TBD technical basis document

U.S.C. United States Code

§ section or sections
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 6 of 29

 

3.1 INTRODUCTION

Technical basis documents (TBDs) 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 historical background information and guidance to assist in the preparation of 

dose reconstructions at particular U.S. Department of Energy (DOE) or Atomic Weapons Employer 

(AWE) facilities or categories of DOE or AWE facilities. They will be revised in the event additional 

relevant information is obtained about the affected DOE or AWE facility(ies), such as changing 

scientific understanding of operations, processes, or procedures involving radioactive materials. 

These documents may be used to assist NIOSH staff in the evaluation of Special Exposure Cohort 

(SEC) petitions and the completion of individual dose reconstructions under Part B of the Energy 

Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA).

In this document the word “facility” is used to refer to an area, building, or group of buildings that 

served a specific purpose at a DOE or AWE facility. It does not mean nor should it be equated to an 

“AWE facility” or a “DOE facility.” The term “AWE facility” is defined in EEOICPA to mean “a facility, 

owned by an atomic weapons employer, that is or was used to process or produce, for use by the 

United States, material that emitted radiation and was used in the production of an atomic weapon, 

excluding uranium mining or milling.” 42 United States Code (U.S.C.) § 7384I(5). On the other hand, a 

DOE facility is defined as “any building, structure, or premise, including the grounds upon which such 

building, structure, or premise is located—(A) in which operations are, or have been, conducted by, or 

on behalf of, the [DOE] (except for buildings, structures, premises, grounds, or operations ... 

pertaining to the Naval Nuclear Propulsion Program); and (B) with regard to which the [DOE] has or 

had—(i) a proprietary interest; or (ii) entered into a contract with an entity to provide management and 

operation, management and integration, environmental remediation services, construction, or 

maintenance services.” 42 U.S.C. § 7384I(12). The DOE determines whether a site meets the 

statutory definition of an AWE facility and the U.S. Department of Labor (DOL) determines if a site is a 

DOE facility and, if it is, designates it as such.

Under EEOICPA, a Part B cancer claim for benefits must be based on an energy employee’s eligible 

employment and occupational radiation exposure at a DOE or AWE facility during the facility’s 

designated time period and location (i.e., a “covered employee with cancer”). After DOL determines 

that a claim meets the eligibility requirements under Part B of EEOICPA, DOL transmits the claim to 

NIOSH for a dose reconstruction. EEOICPA provides, among other things, guidance on eligible 

employment and the types of radiation exposure to be included in an individual dose reconstruction. 

Under EEOICPA, eligible employment at a DOE facility includes individuals who are or were 

employed by DOE and its predecessor agencies, as well as their contractors and subcontractors at 

the facility. 42 U.S.C. § 7384I(11). Also under EEOICPA, the types of exposure to be included in dose 

reconstructions for DOE employees are those radiation exposures incurred in the performance of 

duty. As such, NIOSH includes all radiation exposures received as a condition of employment at DOE 

facilities in its dose reconstructions for covered employees, which may include radiation exposures 

related to the Naval Nuclear Propulsion Program at DOE facilities, if applicable. This is because 

NIOSH does not determine the fraction of total measured radiation exposure at a DOE facility that is 

contributed by the Naval Nuclear Propulsion Program at the DOE facility during a specified period of 

time for inclusion in dose reconstruction.

NIOSH does not consider the following types of exposure as those incurred in the performance of 

duty as a condition of employment at a DOE facility. Therefore these exposures are not included in 

dose reconstructions for covered employees [NIOSH 2010a]:

• Background radiation, including radiation from naturally occurring radon present in 

conventional structures, and

• Radiation from X-rays received in the diagnosis of injuries or illnesses or for therapeutic 

reasons.
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3.1.1 Purpose

The purpose of this TBD is to describe the occupational medical X-ray screening program and 

practices at Los Alamos National Laboratory (LANL). Dose reconstructors will use this information as 

needed to assign medical X-ray doses to workers at LANL.

3.1.2 Scope

LANL had an occupational health program starting in 1949. The purpose of the program was to 

medically screen new personnel, perform termination physicals, discover disease, and periodically 

examine workers exposed to hazards [Hempelman 1946; Shipman 1950a; Los Alamos Scientific 

Laboratory (LASL) 1951, p. 13]. These medical examinations typically included chest X-rays [LASL 

1948]. The doses from these radiographic procedures depended not only on the characteristics of the 

X-ray machine and the procedures used, but also on the frequency of the examinations. This TBD 

describes the technical aspects of X-ray dose from screening X-rays administered before employment 

and periodically thereafter as a condition of employment at LANL. 

3.1.3 Special Exposure Cohort

The Secretary of the U.S. Department of Health and Human Services has designated four classes of 

LANL employees as additions to the SEC based on the findings and recommendations of NIOSH and 

the Advisory Board on Radiation and Worker Health Board.

September 1, 1944, through July 18, 1963, Radioactive Lanthanum

Employees of the Department of Energy predecessor agencies and their contractors or 

subcontractors who were monitored or should have been monitored for exposure to 

ionizing radiation associated with radioactive lanthanum (RaLa) operations at Technical 

Area 10 (Bayo Canyon Site), Technical Area 35 (Ten Site), and Buildings H, Sigma, and 

U (located within Technical Area 1) at the Los Alamos National Laboratory (LANL) for a 

number of work days aggregating at least 250 work days during the period from 

September 1, 1944 through July 18, 1963, or in combination with work days within the 

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

[Leavitt 2006].

NIOSH determined later that it could not limit the class to the specified RaLa operations and areas, 

and the Secretary designated a second class that encompasses the first [NIOSH 2006]. 

March 15, 1943, through December 31, 1975

Employees of DOE, its predecessor agencies, or DOE contractors or subcontractors who 

were monitored or should have been monitored for radiological exposures while working 

in operational TAs with a history of radioactive material use at LANL for a number of 

work days aggregating at least 250 work days from March 15, 1943, through December 

31, 1975, or in combination with work days within the parameters established for one or 

more other classes of employees in the SEC [Leavitt 2007].

Through the course of ongoing dose reconstruction and research, NIOSH determined that, due to 

undocumented worker movements across the site and limited worker-specific information pertaining to 

work locations, it was unable to eliminate any specific worker from potential exposure scenarios 

based on assigned work location. NIOSH has found that a determination cannot always be made as 

to whether or not an employee worked in TAs with a history of radioactive material use, or if an 

employee should have been monitored for radiological exposures. Accordingly, NIOSH determined 

that it was necessary to remove the area-specific and monitoring criteria from the class description 

above, and to expand the SEC class definition to include all areas of LANL, and all employees of the 
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 8 of 29

 

DOE, its predecessor agencies, and their contractors and subcontractors who worked at LANL during 

the specified period, regardless of monitoring. For this reason, the classes of employees listed below 

were added, which encompass both previous classes [NIOSH 2006, 2007]. 

March 15, 1943, through December 31, 1975

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

contractors and subcontractors who worked at the Los Alamos National Laboratory in 

Los Alamos, New Mexico from March 15, 1943 through December 31, 1975, for a 

number of work days aggregating at least 250 work days, occurring either solely under 

this employment or in combination with work days within the parameters established for 

one or more other classes of employees in the Special Exposure Cohort [Sebelius 2010].

January 1, 1976, through December 31, 1995

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

contractors and subcontractors who worked at the Los Alamos National Laboratory 

(LANL) in Los Alamos, New Mexico from January 1, 1976, through December 31, 1995, 

for a number of work days aggregating at least 250 work days, occurring either solely 

under this employment or in combination with work days within the parameters 

established for one or more other classes of employees in the Special Exposure Cohort.

[Sebelius 2012].

NIOSH has determined that it does not have access to sufficient information – including internal 

personnel dosimetry, workplace monitoring data, or sufficient process and radiological source 

information – that would allow it to estimate with sufficient accuracy the potential internal doses 

workers might have received during the above periods. NIOSH has determined that there is 

insufficient information either 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 classes or to estimate the radiation doses of members of the classes more 

precisely than a maximum dose estimate [NIOSH 2010b, 2012].

Although NIOSH found that it is not possible to completely reconstruct radiation doses for the 

proposed class, NIOSH intends to use any internal and external monitoring data that may become 

available for an individual claim (and that can be interpreted using existing NIOSH dose 

reconstruction processes or procedures). Therefore, dose reconstructions for individuals employed at 

LANL during the period from March 15, 1943 through December 31, 1995, but who do not qualify for 

inclusion in the SEC, may be performed using these data as appropriate NIOSH [2010b, 2012]. 

From an occupational external dose reconstruction perspective, partial dose reconstructions can 

include, and are limited to, external dose from gamma emitters from 1946 onward, dose from beta 

emitters from 1949 onward, and neutron dose from 1946 onward.

NIOSH finds that adequate reconstruction of medical dose is likely feasible using claimant-favorable 

assumptions in ORAUT-OTIB-0006, Dose Reconstruction from Occupational Medical X-Ray 

Procedures (OTIB-0006; Oak Ridge Associated Universities [ORAU] Team [ORAUT] 2019), as well 

as LANL technical basis documents, collectively referred to as ORAUT-TKBS-0010 [NIOSH 2010b, 

2012].

3.2 EXAMINATION FREQUENCIES

Table 3-1 lists frequencies of chest X-rays through the years for specific groups of workers. From 

1943 through 1976, workers received preemployment and termination chest X-rays. Hempelman 

recommended annual chest X-rays for workers exposed to radiation and every 6 months for workers 

handling uranium, plutonium, polonium, and beryllium oxide [Hempelman 1944, p. 5]. In addition, 
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 9 of 29

 

because of their exposure to silica flour and ground glass, workers in the glass-blowing shop were to 

be X-rayed every 6 months [Grier and Hardy 1949–1950, p. 5]. 

Table 3-1. Default frequency of occupational chest X-rays. 

Period Workers Chest projections Frequency

1943–1956 All workers Single-projection PFGa,b Preemployment

Termination

1943–1956 Workers handling uranium, plutonium, 

polonium, or beryllium oxide; glass blowersc,d

Single-projection PFGa,b Semiannual

1943–1956 Workers exposed to radiationc Single-projection PFGa,b Annual

1957–1976 All workersc PA Preemployment

Every 3 years

Termination

1977–2001 Workers handling asbestos or beryllium;

workers >45 years olde,f

PA and LATg,h Annual

1977–2001 All other workers <45 years oldf PA and LATg,h Biennial

2002–present Workers monitored for exposure to beryllium, 

asbestos, silica or cadmium; high-altitude

workers; Nano-2 and tower climber workersi

PA and LATj,k Baseline at entry 

into monitoring 

program

2002–present Beryllium, silical and asbestos workers 18-35 

years old; asbestos and silical workers of any 

age that have been exposed to asbestos/silical

<10 years; high-altitude workers ≤40 years oldi

PA and LATj,k (l)

2002–present Asbestos or silica workers 36-45 years old who

have worked with asbestos/silica ≥10 years; 

high-altitude workers >40 years oldi

PA and LATj,l Every 2 years

2002–present Asbestos or silica workers >46 years old who

have worked with asbestos/silica for ≥10 years; 

cadmium workersj

PA and LATi,j,k Annual

2002–present Tower climbersi PA and LATj,k Exit of program

a. Shipman [1955]. 

b. Shipman [1958].

c. Hempelman [1944]. 

d. Grier and Hardy [1949]. 

e. Voelz et al. [1981]. 

f. ERDA [1975].

g. Haynie and Gutierrez [1978].

h. Gutierrez and Haynie [1977]. 

i. Romero [2022]. 

j. Martinez [2021]. 

k. Butler [2022].

l. Every 5 years, except silica workers: every 5 years through September 2021, every 3 years after.

Shipman states that photofluorographs (PFGs) were used unless factors dictated that 14- by 17-in.

film would be better [Shipman 1955, p. 23]. Several historical monthly progress reports document the 

number of PFG and 14- by 17-in. films performed by the occupational medical service and, in almost 

all cases, the number of PFGs exceeded the number of 14- by 17-in. films in a given period, indicating 

the common use of this imaging technique at LANL [Shipman 1949, 1950b, 1955; LASL 1949, p. 19]. 

It appears that both the PFGs and the 14- by 17-in. chest films consisted of a single posterior-anterior 

(PA) projection in the earliest period [Shipman 1949]. Dose reconstructors should be able to identify 

the PFG examinations in the claim file records when a “film number” is recorded on the X-ray record.

The film number indicates the use of roll film (rather than sheet film) commonly used in the PFG 

camera apparatus. Use of PFGs at LANL ended in 1956 [Shipman 1958, p. 35]. 

Shipman writes that the periodic examinations were done every 3 years unless conditions indicated 

otherwise [Shipman 1958, p. 34]. Starting in about 1977, two chest projections (PA and lateral [LAT])
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 10 of 29

 

were being performed routinely for screening [Gutierrez and Haynie 1977; Haynie and Gutierrez 

1978]. No more information is available for the X-ray screening frequency after the late 1970s, 

although documents [e.g., LASL 1979] refer to being in compliance with Chapter 0528 of the U.S. 

Energy Research and Development Administration (ERDA) Contractor Occupational Medical Program 

manual, which required annual X-ray screening for workers more than 45 years old and biennial X-ray 

screening for workers less than 45 years old [ERDA 1975]. In 2002, when the Food and Drug 

Administration performed a survey of the X-ray equipment, the survey questionnaire indicated that 

LANL was no longer routinely performing chest X-ray screening on workers [Antonsen 1998]. From 

2002 to the present, LANL only performed chest X-rays on employees enrolled in the surveillance 

programs listed in Table 3-1 [Martinez 2021, Romero 2022]. The frequency of examinations is 

dependent upon the surveillance program which the employee was enrolled and the employee’s age.

Two historical documents mention the existence of mammography equipment [Valentine 1989, p. 95] 

and mammography screening [Wade 1991, p. 16]. Mammography screening was likely offered to 

employees as a convenience to them. Mammography would not have been used to screen for 

occupational disease. For this reason, and because mammography screening is commonplace in the 

general population and the risk from exposure to mammography screening is assumed to be included 

in the risk models of the Interactive RadioEpidemiological Program (IREP), dose from mammography 

is not included as part of occupational medical dose in this TBD [NIOSH 2002]. 

LANL medical records, including X-ray records, are available from LANL on special request. The 

records state if the X-ray was “routine” (i.e., screening, sometimes abbreviated “Rt”), or “special” (i.e., 

diagnostic – not screening). The records also provide the worker’s employer at LANL (Zia, ERDA, 

U.S. Atomic Energy Commission, University of California, etc.). Refer to Section 3.4.1 for guidance in 

assigning X-ray doses.

3.3 EQUIPMENT AND TECHNIQUES

Organ doses from occupational medical X-rays at LANL are presented for all types of X-ray 

equipment employed over the operational period. The types of X-ray equipment used are listed in 

Table 3-2. Tables 3-3 and 3-4 list the specific technique factors reported by LANL along with 

measured or estimated beam qualities for the different machines. Table 3-4 includes the half-value 

layers (HVLs) that were used to select the dose conversion factors (DCFs) for dose calculation.
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Table 3-2. X-ray equipment.a

Technique Period Equipment

PFG 1943–1956 Unknown, 70-mm fluororoentgenogram, single exposure. Default values from 

OTIB-0006 for one nonstereo exposure should be used for this period.

Type I(a) 1943–1970 Unknown. Default values for 14- by 17–in. radiographic chest from OTIB-0006

should be used for this period.

Type I(b) 1971–1975 Unknown. Default values for 14- by 17–in. radiographic chest from OTIB-0006

should be used for this period.

Type II 1976–1984 General Electric KX810; 3.75-mm total filtration should be assumed for this 

period.

Type III 1985–1994 General Electric DXD 350Il Control, Single-Phase Generator, Auto Collimator, 

12:1 Grid, 3.5-mm Al equivalent total filtration. Kodak X-Omatic 90-s cold-water 

processor, 400-speed film-screen system, Kodak Lanex cassettes-rare earth.

Fuji Ortho G film [Antonsen 1998; Shalkowski et al. 1991].

Type IVb 1995–2002 General Electric DXD 350Il Control, Single-Phase Generator, Auto Collimator, 

12:1 Grid, 3.5-mm Al equivalent total filtration. Kodak X-Omatic 90-s cold-water 

processor, 400-speed film-screen system, Kodak Lanex cassettes-rare earth.

Fuji Ortho G film [Antonsen 1998].

Type V 2003–2014c Quantum Medical Imaging Cosmos 22 Control, High Frequency Generator, 

Varian X-ray tube, Heustis medical collimator. 2.5-mm Al equivalent total

filtration. CXDI22 Canon sensor-digital camera [Velarde 2009].

Type VIc 2015–2020 Quantum Model QG-6500, Odyssey HF Series Three Phase Generator, 2.5-mm 

Al equivalent total filtration [Martinez 2021].

Type VIIc 2021–present Del Medical Model FMT18M Digital Unit, 1.5-mm Al equivalent total filtration

[Martinez 2021].

a. OTIB-0006 = Oak Ridge Associated Universities (ORAU) Team (ORAUT) [2019].

b. Type IV equipment same as Type III, different technique factors used.

c. Source: Martinez [2021].

Table 3-3. Technique factors used for each type of X-ray equipment. 

Machine Projectiona

Current

(mA)

Voltage

(kVp)

Exposure time

(s)

Type I(a) 1943–1970 Unknown Unknown Unknown Unknown

Type I(b) 1971–1975 Unknown Unknown Unknown Unknown

Type II 1976–1984b PA chest 300 90 1/30

Type III 1985–1994c PA chest 200 102 1/30

Type IV 1995–2002d PA chest 200 114 1/50

Type V 2003–2014e PA chest 200 104 1/30

Type VI 2015–2020e PA chest 800 80 1/125

Type VII 2021–presente PA chest 3.2 (mAs) 120 Not applicable

a. The average PA chest measures 24 cm; the average LAT chest measures 36 cm.

b. Source: Gutierrez and Haynie [1976]. 

c. Source: Shalkowski et al. [1991]. 

d. Source: Antonsen [1998]. 

e. Source: Martinez [2021].
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Table 3-4. HVLs (mm) used to determine DCFs for dose calculations.a

Machine 

type

Periods of 

use

Total filtration 

[Al equiv.] 

(reported or estimated)

HVL based on 

filtration and kVpb

HVL used for DCF 

selectionc

PFG 1943–1956 Unknown (2.5)d 2.5 2.5

Type Ia 1943–1970 Unknown (2.5)d 2.5 2.5

Type Ib 1971–1975 Unknown (2.5)d 2.5 2.5

Type II 1976–1984e 3.75 3.3 at 90 kVp 3.5

Type III 1985–1994f 3.5 3.4 at 100 kVp 3.5

Type IV 1995–2002g 3.5 3.7 at 110 kVp 4.0

Type V 2003–2014h 2.5 3.4 3.5

Type VI 2015–2020h 2.5 2.5 2.5

Type VII 2021–presenth 1.5 1.5 1.5

a. ICRP = International Commission on Radiological Protection; NCRP = National Council on Radiation Protection and 

Measurements.

b. [NCRP 1989].

c. [ICRP 1982]. 

d. Source: Based on OTIB-0006. 

e. Source: Gutierrez and Haynie [1976]. 

f. Source: Shalkowski et al. [1991]. 

g. Source: Antonsen [1998]. 

h. Source: Martinez [2021]. 

As mentioned above, PFGs were performed from 1943 to 1956 [Shipman 1955, 1958]. During this 

time, chest X-rays were also performed on 14- by 17-in. film [Shipman 1954], but nothing is known 

about this equipment except that it was probably in the hospital [Shipman 1952]. The first mention of a 

specific brand and model of X-ray equipment is in Gutierrez and Haynie [1976]. The General Electric 

X-ray machine is mentioned, along with the technical information from a survey of that machine in the 

new occupational medical building. Even though Gutierrez and Haynie show a possible total filtration 

of 6.75-mm Al equivalent resulting from the summation of the individual component filtration 

equivalents, it seems doubtful that this much filtration was actually used for the following reasons: 

• To obtain the possible total of 6.75-mm Al eq., the equivalent filtration of the collimator and the 

removable filters were added together. Removable filters (placed in a slot) were usually used 

with a cone-type beam-limiting device because such a device did not have any inherent 

filtration. However, an adjustable collimator does have some inherent filtration. Apparently, an 

adjustable light-localizing collimator was added to this machine [Gutierrez and Haynie 1976], 

making removable filters unnecessary. When the thickness of the removable filters is left out of 

the summation, the total is about 3.75-mm Al eq., which is a much more reasonable amount.

• It is extremely doubtful that a radiologist would have accepted radiographs produced with 

6.75-mm Al filtration. With that much filtration, there would have been little differential 

absorption in tissue and little contrast in the image. 

For these reasons, the total filtration for this period is assumed to be 3.75-mm Al eq., which results in 

an HVL of 3.3-mm Al at 90 kVp.

Another General Electric machine, the DXD 350ll, was installed in 1985 and used until approximately 

2003 [Antonsen 1998]. In 2003, a Quantum Medical Imaging Odyssey X-ray machine was installed 

[Velarde 2009]. It was replaced with a Quantum Model QG-6500, Odyssey HF Series Three Phase 

Generator in 2015. In 2021, a Del Medical Model FMT18M Digital Unit was installed [Martinez 2021].
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 13 of 29

 

3.4 ORGAN DOSES

This section presents X-ray organ doses for occupational X-rays at LANL for all types of equipment 

and all periods. 

Dose values for PFGs at LANL are based on the default values for PFGs in OTIB-0006, except that 

the doses are calculated for single-exposure PFGs (not stereo exposures). The PFG doses in OTIB0006 are divided by 2 to obtain single-exposure PFG doses. Dose reconstructors should be able to 

identify the PFGs in the claim file records when the examination occurred between 1943 and 1956 

and when a “film number” is recorded; the latter indicates the use of roll rather than sheet film. Dose 

reconstructors should assume a two-exposure stereo PFG only when the words “serial 1 and 2” 

appear on the record or radiologist’s interpretation.

Dose values for conventional 14- by 17-in. chest radiography for LANL from 1943 to 1975 are also 

based on the default values for chest radiography in OTIB-0006. 

Organ Dose

Dose values for the remaining periods, with the exception of 1985 to 1994 and 2015 to 2020, were

calculated using average air kerma rates from Figure A-1 of the International Commission on 

Radiological Protection (ICRP) Publication 34 [ICRP 1982] in units of mGy/mAs at 100 cm. The data 

in Figure A-1 were corrected to a source-to-skin distance (SSD) of 154 cm and for the actual voltage, 

current, and phase of the machines for the various periods. An example calculation is shown below: 

(3-1)

2

, (1976-1984) , (ICRP34)

1 0.1cGy/mGy 00

154

Ka i K Current ExposureTime a i

 

= × × ××    

where

Ka,i(1976-1984) = incident air kerma in air (cGy)

Ka,i(ICRP34) = incident air kerma in air from ICRP Publication 34 (mGy/mAs)

Current = mA

Exposure Time = s 

Therefore

(3-2)

2

, (1976-1984)

100 0.045 mGy/mAs 300 mA 0.0333s 0.1cGy/mGy 154

0.01897 cGy

Ka i

 

= × × ××    

=

where

Ka,i(1976-1984) = incident air kerma in air for 1976 to 1984 (cGy)

For the period 1985 to 1994 the actual measured air kerma rate was used [Olsher 1991]. A 

conversion factor from the Quantum X-ray machine was used to calculate air kerma for the 2015 to 

2020 period [Martinez 2021]. For both PA and LAT chest projections, a standard source-to-image 

distance of 72 in. (183 cm) was assumed for all periods. In accordance with OTIB-0006, entrance air 

kerma in air from the LAT chest projection is estimated at 2.5 times more than the PA entrance 

kerma. It was assumed that all the X-ray machines were single-phase except the high-frequency Type 

V, VI, and VII units. The values for the high-frequency units from Figure A-1 were multiplied by a 

factor of 1.8 [ICRP 1982]. ICRP Publication 34 [ICRP 1982] contains tables of average absorbed dose 

(milligray) in selected organs for selected X-ray projections at 1-Gy entrance kerma (i.e., air kerma 
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 14 of 29

 

without backscatter) and selected beam qualities (i.e., various HVLs). The organ doses were 

calculated by multiplying the ICRP organ DCFs by the entrance air kerma in air. The resulting organ 

doses for all machines and periods are listed in Table 3-5 [ORAUT 2022a]. 

Skin Dose

Skin doses were calculated using the method described in OTIB-0006. Table 3-6 lists the skin dose 

guidance for various areas of skin for various projections. Table 3-7 lists skin doses from all machines 

and periods calculated according to the guidance [ORAUT 2022a].

Doses were generally determined by analogy with anatomical location for organs not listed in ICRP 

Publication 34 [ICRP 1982] but specified in IREP in accordance with the guidance in OTIB-0006. 

Chronic Lymphocytic Leukemia

The tissues at risk for chronic lymphocytic leukemia are the B-lymphocytes. The dose to the

B-lymphocytes was determined using the method in ORAUT-RPRT-0064, Medical Dose to the 

B-Lymphocytes [ORAUT 2014], site-specific information, and ICRP Publication 34 DCFs [ICRP 1982]. 

Dose values for the B-lymphocytes for conventional 14- by 17-in. chest radiography for LANL from 

1943 to 1975 are based on the values in OTIB-0006. Dose values for the B-lymphocytes for PFGs for 

LANL from 1943 to 1956 are based on the values in ORAUT-RPRT-0064. Table 3-8 provides dose 

distributions and statistical parameters for input into IREP for determining dose to the B-lymphocytes. 
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

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Table 3-5. Organ dose equivalents (rem) for chest projections, all periods.a

PA

Organ

PFG 

1943–1956b 1943–1970c 1971–1975c 1976–1984 1985–1994 1995–2002 2003–2014

2015–

08/2021

09/2021–

present

Thyroid 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.18E-03 1.36E-03 9.36E-04 2.64E-03 5.32E-04 2.98E-04

Eye/brain 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.18E-03 1.36E-03 9.36E-04 2.64E-03 5.32E-04 2.98E-04

Ovaries 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 6.08E-05 7.04E-05 6.24E-05 1.36E-04 1.66E-05 5.42E-06

Urinary/bladder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 6.08E-05 7.04E-05 6.24E-05 1.36E-04 1.66E-05 5.42E-06

Colon/rectum 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 6.08E-05 7.04E-05 6.24E-05 1.36E-04 1.66E-05 5.42E-06

Testes 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.90E-07 2.20E-07 1.20E-07 4.25E-07 1.66E-07 2.71E-07

Lung (male) 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.07E-02 1.24E-02 7.54E-03 2.40E-02 6.97E-03 6.58E-03

Lung (female) 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Thymus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Esophagus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Stomach 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Bone surface 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Liver/gall 

bladder/ spleen

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Remainder 

organs

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.16E-02 1.34E-02 8.09E-03 2.59E-02 7.50E-03 6.77E-03

Breast 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.73E-03 2.00E-03 1.39E-03 3.87E-03 8.15E-04 4.88E-04

Uterus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 5.70E-05 6.60E-05 6.24E-05 1.28E-04 2.16E-05 8.13E-06

Bone marrow 

(male)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.77E-03 3.21E-03 2.14E-03 6.21E-03 1.53E-03 1.33E-03

Bone marrow 

(female)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.68E-03 3.10E-03 2.06E-03 5.99E-03 1.43E-03 1.17E-03

ENSDd 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

LAT

Organ

PFG 

1943–1956b 1943–1970c 1971–1975c 1976–1984 1985–1994 1995–2002 2003–2014

2015–

08/2021

09/2021–

present

Thyroid 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.17E-03 8.31E-03 4.92E-03 1.60E-02 4.78E-03 4.67E-03

Eye/brain 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.17E-03 8.31E-03 4.92E-03 1.60E-02 4.78E-03 4.67E-03

Ovaries 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.60E-05 8.80E-05 7.50E-05 1.70E-04 2.50E-05 6.77E-06

Urinary/bladder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.60E-05 8.80E-05 7.50E-05 1.70E-04 2.50E-05 6.77E-06

Colon/rectum 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.60E-05 8.80E-05 7.50E-05 1.70E-04 2.50E-05 6.77E-06

Testes 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 4.75E-06 5.50E-06 3.00E-06 1.06E-05 4.16E-06 6.77E-06

Lung (male) 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.31E-02 1.52E-02 9.39E-03 2.93E-02 8.03E-03 6.91E-03

Lung (female) 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Thymus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

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Organ

PFG 

1943–1956b 1943–1970c 1971–1975c 1976–1984 1985–1994 1995–2002 2003–2014

2015–

08/2021

09/2021–

present

Esophagus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Stomach 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Bone surface 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Liver/gall 

bladder/ spleen

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Remainder 

organs

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Breast 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.50E-02 1.74E-02 1.03E-02 3.36E-02 1.06E-02 1.30E-02

Uterus 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 6.65E-05 7.70E-05 6.30E-05 1.49E-04 2.50E-05 6.77E-06

Bone marrow 

(male)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.90E-03 3.36E-03 2.28E-03 6.48E-03 1.54E-03 1.35E-03

Bone marrow 

(female)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.28E-03 2.64E-03 1.77E-03 5.10E-03 1.21E-03 9.48E-04

ENSDd 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

a. Source: ORAUT [2022a].

b. See OTIB-0006 and apply 50% because LANL did not typically perform stereo PFGs. 

c. See OTIB-0006 and apply 100% before 1976.

d. ENSD = entrance skin dose. ENSD is determined by multiplying the entrance air kerma in air by the backscatter factors of 1.28, 1.35, 1.40, and 1.42 for HVL of 

1.5-mm Al, 2.5-mm, 3.0- or 4.0-mm Al, respectively, from NCRP Report 102 [NCRP 1989, Table B-8]. Skin doses for all areas of skin are provided in Table 3-7. 

Table 3-6. Skin dose guidance for chest projections, all periods.

a

Area of skin PFG

PA

through 1970

PA

after 1970

LAT

after 1970

Right front shoulder EXSD EXSD EXSD ENSD

Right back shoulder ENSD ENSD ENSD ENSD

Left front shoulder EXSD EXSD EXSD EXSD

Left back shoulder ENSD ENSD ENSD EXSD

Right upper arm to elbow 10% ENSD ENSD 10% ENSD ENSD

Left upper arm to elbow 10% ENSD ENSD 10% ENSD EXSD

Left hand ENSD ENSD 10% ENSD 10% ENSD

Right hand ENSD ENSD 10% ENSD 10% ENSD

Left elbow, forearm, wrist 10% ENSD ENSD 10% ENSD 10% ENSD

Right elbow, forearm, wrist 10% ENSD ENSD 10% ENSD 10% ENSD

Right side of head (including ear and temple) 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Left side of head (including ear and temple) 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Front left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Front right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Left knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

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Area of skin PFG

PA

through 1970

PA

after 1970

LAT

after 1970

Right knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

Left side of face Eye/brain Eye/brain Eye/brain 10% ENSD

Right side of face Eye/brain Eye/brain Eye/brain 10% ENSD

Left side of neck 10% ENSD ENSD 10% ENSD 10% ENSD

Right side of neck 10% ENSD ENSD 10% ENSD 10% ENSD

Back of head 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Front of neck Eye/brain Eye/brain Thyroid 10% ENSD

Back of neck 10% ENSD ENSD 10% ENSD 10% ENSD

Front torso: base of neck to end of sternum EXSD EXSD EXSD Lung

Front torso: end of sternum to lowest rib EXSD EXSD EXSD Lung

Front torso: lowest rib to iliac crest EXSD EXSD 10% EXSD 10% lung

Front torso: iliac crest to pubis 10% EXSD 10% EXSD 10% EXSD 10% lung

Back torso: base of neck to mid-back ENSD ENSD ENSD Lung

Back torso: mid-back to lowest rib ENSD ENSD ENSD Lung

Back torso: lowest rib to iliac crest ENSD ENSD 10% ENSD 10% lung

Back torso: buttocks (Iliac crest and below) 10% ENSD 10% ENSD 10% ENSD 10% lung

Right torso: base of neck to end of sternum ENSD ENSD ENSD ENSD

Right torso: end of sternum to lowest rib ENSD ENSD ENSD ENSD

Right torso: lowest rib to iliac crest ENSD ENSD 10% ENSD 10% ENSD

Right torso: iliac crest to pubis (right hip) 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Left torso: base of neck to end of sternum ENSD ENSD ENSD EXSD

Left torso: end of sternum to lowest rib ENSD ENSD ENSD EXSD

Left torso: lowest rib to iliac crest ENSD ENSD 10% ENSD 10% EXSD

Left torso: iliac crest to pubis (left hip) 10% ENSD 10% ENSD 10% ENSD 10% EXSD

a. EXSD = exit skin dose; RSD = remote skin dose.

Table 3-7. Skin dose (rem) from chest projections, 1943 to present. 

PA

Area of skin

PFG 

1943–1956a 1943–1970b 1971–1975b

1976–

1984c 

1985–

1994c

1995–

2002c

2003–

2014c

2015–

08/2021c

09/2021–

presentc

Right front shoulder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-04 8.98E-04 5.78E-04 1.73E-03 4.76E-04 2.67E-04

Right back shoulder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Left front shoulder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-04 8.98E-04 5.78E-04 1.73E-03 4.76E-04 2.67E-04

Left back shoulder 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Right upper arm to elbow 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Left upper arm to elbow 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Left hand 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right hand 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

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Area of skin

PFG 

1943–1956a 1943–1970b 1971–1975b

1976–

1984c 

1985–

1994c

1995–

2002c

2003–

2014c

2015–

08/2021c

09/2021–

presentc

Left elbow, forearm, wrist 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right elbow, forearm, wrist 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right side of head including ear 

and temple

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Left side of head including ear 

and temple

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Front left thigh 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 9.55E-06 1.11E-05 6.67E-06 2.14E-05 6.45E-06 5.15E-06

Back left thigh 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 9.55E-06 1.11E-05 6.67E-06 2.14E-05 6.45E-06 5.15E-06

Front right thigh 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 9.55E-06 1.11E-05 6.67E-06 2.14E-05 6.45E-06 5.15E-06

Back right thigh 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 9.55E-06 1.11E-05 6.67E-06 2.14E-05 6.45E-06 5.15E-06

Left knee and below 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 3.49E-06 4.04E-06 2.44E-06 7.81E-06 2.36E-06 1.88E-06

Right knee and below 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 3.49E-06 4.04E-06 2.44E-06 7.81E-06 2.36E-06 1.88E-06

Left side of face 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.18E-03 1.36E-03 9.36E-04 2.64E-03 5.32E-04 2.98E-04

Right side of face 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.18E-03 1.36E-03 9.36E-04 2.64E-03 5.32E-04 2.98E-04

Left side of neck 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right side of neck 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Back of head 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Front of neck 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 1.18E-03 1.36E-03 9.36E-04 2.64E-03 5.32E-04 2.98E-04

Back of neck 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Front torso: base of neck to end 

of sternum

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-04 8.98E-04 5.78E-04 1.73E-03 4.76E-04 2.67E-04

Front torso: end of sternum to 

lowest rib

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-04 8.98E-04 5.78E-04 1.73E-03 4.76E-04 2.67E-04

Front torso: lowest rib to iliac 

crest

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-05 8.98E-05 5.78E-05 1.73E-04 4.76E-05 2.67E-05

Front torso: iliac crest to pubis 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 7.75E-05 8.98E-05 5.78E-05 1.73E-04 4.76E-05 2.67E-05

Back torso: base of neck to mid–

back

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Back torso: mid–back to lowest 

rib

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Back torso: lowest rib to iliac 

crest

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Back torso: buttocks (Iliac crest 

and below)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right torso: base of neck to end

of sternum

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Right torso: end of sternum to 

lowest rib

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

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Area of skin

PFG 

1943–1956a 1943–1970b 1971–1975b

1976–

1984c 

1985–

1994c

1995–

2002c

2003–

2014c

2015–

08/2021c

09/2021–

presentc

Right torso: lowest rib to iliac 

crest

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Right torso: iliac crest to pubis 

(right hip)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Left torso: base of neck to end of 

sternum

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Left torso: end of sternum to 

lowest rib

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-02 3.08E-02 1.70E-02 5.95E-02 2.25E-02 3.47E-02

Left torso: lowest rib to iliac crest 50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

Left torso: iliac crest to pubis 

(left hip)

50% OTIB-0006 100% OTIB-0006 100% OTIB-0006 2.66E-03 3.08E-03 1.70E-03 5.95E-03 2.25E-03 3.47E-03

LAT

Area of skin 1976–1984c 1985–1994c 1995–2002c 2003–2014c 2015–08/2021c 09/2021–presentc

Right front shoulder 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

Right back shoulder 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

Left front shoulder 4.08E-04 4.73E-04 3.19E-04 9.13E-04 2.46E-04 1.04E-04

Left back shoulder 4.08E-04 4.73E-04 3.19E-04 9.13E-04 2.46E-04 1.04E-04

Right upper arm to elbow 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

Left upper arm to elbow 4.08E-04 4.73E-04 3.19E-04 9.13E-04 2.46E-04 1.04E-04

Left hand 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right hand 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Left elbow, forearm, wrist 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right elbow, forearm, wrist 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right side of head including ear and temple 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Left side of head including ear and temple 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Front left thigh 1.14E-05 1.32E-05 8.08E-06 2.55E-05 7.56E-06 5.83E-06

Back left thigh 1.14E-05 1.32E-05 8.08E-06 2.55E-05 7.56E-06 5.83E-06

Front right thigh 1.14E-05 1.32E-05 8.08E-06 2.55E-05 7.56E-06 5.83E-06

Back right thigh 1.14E-05 1.32E-05 8.08E-06 2.55E-05 7.56E-06 5.83E-06

Left knee and below 4.16E-06 4.82E-06 2.95E-06 9.31E-06 2.76E-06 2.13E-06

Right knee and below 4.16E-06 4.82E-06 2.95E-06 9.31E-06 2.76E-06 2.13E-06

Left side of face 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right side of face 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Left side of neck 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right side of neck 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Back of head 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Front of neck 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Back of neck 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03
 

Document No. ORAUT-TKBS-0010-3 Revision No. 0

2 Effective Date: 01/10/2023 Page 20 of 29

Area of skin 1976–1984c 1985–1994c 1995–2002c 2003–2014c 2015–08/2021c 09/2021–presentc

Front torso: base of neck to end of sternum 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Front torso: end of sternum to lowest rib 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Front torso: lowest rib to iliac crest 1.47E-03 1.71E-03 1.05E-03 3.29E-03 9.15E-04 7.79E-04

Front torso: iliac crest to pubis 1.47E-03 1.71E-03 1.05E-03 3.29E-03 9.15E-04 7.79E-04

Back torso: base of neck to mid–back 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Back torso: mid–back to lowest rib 1.47E-02 1.71E-02 1.05E-02 3.29E-02 9.15E-03 7.79E-03

Back torso: lowest rib to iliac crest 1.47E-03 1.71E-03 1.05E-03 3.29E-03 9.15E-04 7.79E-04

Back torso: buttocks (Iliac crest and below) 1.47E-03 1.71E-03 1.05E-03 3.29E-03 9.15E-04 7.79E-04

Right torso: base of neck to end of sternum 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

Right torso: end of sternum to lowest rib 6.65E-02 7.70E-02 4.26E-02 1.49E-01 5.62E-02 9.48E-02

Right torso: lowest rib to iliac crest 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Right torso: iliac crest to pubis (right hip) 6.65E-03 7.70E-03 4.26E-03 1.49E-02 5.62E-03 9.48E-03

Left torso: base of neck to end of sternum 4.08E-04 4.73E-04 3.19E-04 9.13E-04 2.46E-04 1.04E-04

Left torso: end of sternum to lowest rib 4.08E-04 4.73E-04 3.19E-04 9.13E-04 2.46E-04 1.04E-04

Left torso: lowest rib to iliac crest 4.08E-05 4.73E-05 3.19E-05 9.13E-05 2.46E-05 1.04E-05

Left torso: iliac crest to pubis (left hip) 4.08E-05 4.73E-05 3.19E-05 9.13E-05 2.46E-05 1.04E-05

a. See OTIB-0006 and apply 50% because LANL did not typically perform stereo PFGs. 

b. See OTIB-0006 and apply 100% before 1976.

c. Source: ORAUT [2022a].
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 21 of 29

 

Table 3-8. IREP dose distributions and statistical parameters for the dose to the B-lymphocytes.a

Projection and 

period IREP distribution Parameter 1 Parameter 2 Parameter 3

PFG 1943–1956 Use ORAUT 

2014

Use ORAUT 

2014

Use ORAUT 

2014

Use ORAUT 

2014

PA 1943–1970 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006

LAT 1943–1970 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006

PA 1971–1975 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006

LAT 1971–1975 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006 Use OTIB-0006

PA 1976–1984 Weibull3 2.074754 0.004981 1.78162E-05

LAT 1976–1984 Weibull3 2.105124 0.006356 9.87032E-06

PA 1985–1994 Weibull3 2.049242 0.005697 7.05969E-05

LAT 1985–1994 Weibull3 2.082033 0.007364 2.67307E-06

PA 1995–2002 Weibull3 2.115078 0.00352 1.92489E-05

LAT 1995–2002 Weibull 2.120687 0.00459 N/A

PA 2003–2014 Weibull3 2.105327 0.0113 7.82527E-06

LAT 2003–2014 Weibull3 2.086014 0.014163 3.20232E-05

PA 2015–2020 Weibull 2.060644 0.003235 N/A

LAT 2015–2020 Lognormal 0.002992614b 1.717928149b N/A

PA 2021–present Weibull 2.045486 0.002831 N/A

LAT 2021–present Weibull3 2.061269 0.003303 1.18406E-05

a. Source: ORAUT [2022b]; N/A = not applicable.

b. For the Lognormal 3 and Lognormal 2 distributions, the geometric mean and geometric standard deviation are 

calculated by exponentiating μ and σ, respectively (GM = exp(μ), GSD = exp(σ)) [ORAUT 2022b].

3.4.1 Dose Reconstruction Guidance

The information given below summarizes instructions given to the dose reconstructors in determining 

organ doses from occupational medical X-ray procedures. For the purpose of evaluating probability of 

causation, X-ray doses are always considered acute and to reflect photons with energies in the range 

from 30 to 250 keV. X-ray doses are assigned in IREP with a normal distribution in IREP Parameter 1 

and the product of the organ dose multiplied by an uncertainty of 0.3 in Parameter 2 for the purpose of 

calculating probability of causation [ORAUT 2017].

3.4.1.1 Maximizing Approach

To maximize X-ray dose before 1957, assign X-rays based on the frequency in Table 3-1. If there is 

evidence of more frequent X-rays in the energy employee’s medical record, those X-rays should be 

assigned. After 1956, assign annual X-rays for all years of employment. If there is evidence of more 

frequent X-rays in the energy employee’s medical record, those X-rays should be assigned. Refer to 

OTIB-0006 for PFG and PA chest X-ray examination doses before 1976 [ORAUT 2019] and to 

Tables 3-5 and 3-7 for such doses after 1975. Refer to OTIB-0006 for examination doses for 

examinations other than PA chest X-rays if found in the worker’s records and determined to be 

occupational in nature.

3.4.1.2 Best-Estimate Approach

Assign X-rays based on the actual X-ray records provided by the site. LANL provides all employee 

X-ray records in the medical record. Therefore, if no X-rays are provided in the medical record, it is 

likely the employee did not receive any X-rays. If no medical records are provided in the DOE or DOL 

record, request the medical records from the site to confirm that the employee did not receive any 

X-rays. If no medical records are received, following the request, the dose reconstructor should 

assume no X-ray exams were performed and no X-rays should be assigned. Refer to OTIB-0006 for 

PFG and PA chest X-ray examination doses before 1976 [ORAUT 2019] and to Tables 3-5 and 3-7 
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 22 of 29

 

for such doses after 1976. Refer to OTIB-0006 for examination doses for examinations other than PA 

chest X-rays if found in the worker’s records and determined to be occupational in nature.

3.5 UNCERTAINTY

Although many factors can introduce uncertainty and error into X-ray dose estimates, five factors 

contribute the most: measurement error (±2%), variation in peak kilovoltage (±9%), variation in beam 

current (±5%), variation in exposure time (±25%), and distance from the worker to the source of the 

X-rays (SSD) (±10%) [ORAUT 2019]. Other variables, such as the use of screens and grids, 

reciprocity failure, and film speed and development, do not affect the beam output intensity [OTIB0006].

A reasonable approach is to assume that the uncertainties are in fact random and therefore to 

compute the combined statistical uncertainty as the square root of the sum of the squares of all the 

uncertainties: (22 + 92 + 52 + 252 + 102

)

1/2, which equals ±28.9%. Rounding this up to ±30% provides 

an adequate and suitably conservative indication of uncertainty. Therefore, for a derived dose 

equivalent to an individual organ, a total combined standard uncertainty of ±30% can be assumed. 

Dose reconstructors should, therefore, input the organ dose equivalent as the mean of a normal 

distribution, with a standard uncertainty of ±30%.
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 23 of 29

 

REFERENCES

Antonsen RG Jr. [1998]. Survey results, GE - DXD 350II x-ray system. Letter to P.E. Cruz, Los

Alamos National Laboratory. Denver, CO: U.S. Department of Health and Human Services, Public 

Health Service, Food and Drug Administration. August 6. [SRDB Ref ID: 188242] 

Butler BM [2022]. LANL response to data request LANL FY21-006 supplemental x-ray information. 

Los Alamos, NM. July 27 [SRDB Ref ID: 193222] 

ERDA [1975]. ERDA manual - Chapter 0528 ERDA contractor occupational medical program. 

Washington, DC: U.S. Energy Research and Development Administration. ERDA 0528-01, August 21. 

[SRDB Ref ID: 4643]

Grier RS, Hardy HL [1949–1950]. Progress report Occupational Health Group H-2. Los Alamos 

Scientific Laboratory, Los Alamos, NM: University of California. [SRDB Ref ID: 28650] 

Gutierrez JA, Haynie JS [1976]. H-2 occupational medicine building x-ray survey. Memorandum to 

R.S. Grier. Los Alamos Scientific Laboratory, Los Alamos, NM: University of California. October 4. 

[SRDB Ref ID: 28602]

Gutierrez JA, Haynie JS [1977]. Six month radiation survey at H-2 occupational medicine building, 

TA-3-409. Memorandum to R.S. Grier. Los Alamos Scientific Laboratory, Los Alamos, NM: University 

of California. May 16. [SRDB Ref ID: 28604]

Haynie JS, Gutierrez JA [1978]. Six month radiation survey at H-2 occupational medical building, 

TA-3, SM-409. Memorandum to R.S. Grier. Los Alamos Scientific Laboratory, Los Alamos, NM: 

University of California. August 10. [SRDB Ref ID: 14069]

Hempelman L [1944]. Health report. Los Alamos Scientific Laboratory, Los Alamos, NM: University of 

California. April 14. [SRDB Ref ID: 994]

Hempelman L [1946]. History of the Health Group (A-6) (March 1943 - November 1945). Los Alamos 

Scientific Laboratory, Los Alamos, NM: University of California. April 6. [SRDB Ref ID: 12894] 

ICRP [1982]. ICRP 34 - Protection of the patient in diagnostic radiology. ICRP Publication 34. Ann 

ICRP 9(2-3). [SRDB Ref ID: 32466]

LASL [1948]. H-Division progress report 21 December 1947 - 20 January 1948. Los Alamos Scientific 

Laboratory, Los Alamos, NM: University of California. LAMS-687, February 5. [SRDB Ref ID: 188266] 

LASL [1949]. H-Division progress report 20 May 1949 - 20 June 1949. Los Alamos Scientific 

Laboratory, Los Alamos, NM: University of California. LAMS-917, September 7. [SRDB Ref ID: 7884]

LASL [1951]. Annual report Health Division 1950. Los Alamos Scientific Laboratory, Los Alamos, NM: 

University of California. LA-1256, May 25. [SRDB Ref ID: 29155]

LASL [1979]. Operational environmental health and safety activities quarterly progress report April - 

June 1979. Los Alamos Scientific Laboratory, Los Alamos, NM: University of California. [SRDB Ref 

ID: 46391]
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 24 of 29

 

Leavitt MO [2006]. 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 Los Alamos National Laboratory (LANL) Los Alamos, New Mexico. Washington, DC: 

U.S. Department of Health and Human Services, Office of the Secretary. November 9. [SRDB Ref ID: 

169469]

Leavitt MO [2007]. 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 Los Alamos National Laboratory (LANL) Los Alamos, New Mexico. Washington, DC: 

U.S. Department of Health and Human Services, Office of the Secretary. June 22. [SRDB Ref ID: 

48179]

Martinez AN [2021]. LANL response to data request LANL FY21-006 for updated medical x-ray 

information. Los Alamos National Laboratory, Los Alamos, NM: Triad National Security. October 14. 

[SRDB Ref ID: 190379]

NCRP [1989]. NCRP Report 102 - Medical x-ray, electron beam and gamma-ray protection for 

energies up to 50 MeV (equipment design, performance and use). Bethesda, MD: National Council on 

Radiation Protection and Measurements. June 30. [SRDB Ref ID: 32467]

NIOSH [2002]. NIOSH-Interactive RadioEpidemiological Program (NIOSH-IREP) technical 

documentation. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease 

Control and Prevention, National Institute for Occupational Safety and Health. June 18. [SRDB Ref ID: 

22398] 

NIOSH [2006]. Special Exposure Cohort petition evaluation report petition SEC-00061 Rev. 08-18-06

Los Alamos National Laboratory (LANL) qualified June 7, 2006. Cincinnati, OH: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health. Rev. 08-18-06, August 18. [SRDB Ref ID: 79894]

NIOSH [2007]. Special Exposure Cohort petition evaluation report petition SEC-00051 Rev. 0

Addendum-1 Addendum-2 Los Alamos National Laboratory (LANL) qualified August 7, 2006. 

Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention, National Institute for Occupational Safety and Health. Rev. 0 Addendum-1 Addendum-2, 

June 4. [SRDB Ref ID: 41108]

NIOSH [2010a]. Radiation exposures covered for dose reconstructions under Part B of the Energy 

Employees Occupational Illness Compensation Program Act. Cincinnati, OH: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health. DCAS-IG-003 Rev. 1, October 5. [SRDB Ref ID: 88929]

NIOSH [2010b]. Special Exposure Cohort petition evaluation report petition SEC-00170 Rev. 0 Los 

Alamos National Laboratory (LANL) qualified April 27, 2010. Cincinnati, OH: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health. Rev. 0, April 26. [SRDB Ref ID: 169471]

NIOSH [2012]. Special Exposure Cohort petition evaluation report petition SEC-00109 Rev. 1 Los 

Alamos National Laboratory (LANL) qualified May 29, 2008. Cincinnati, OH: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, National Institute for 

Occupational Safety and Health. Rev. 1, August 13. [SRDB Ref ID: 165232] 

Olsher R [1991]. Survey results, GE x-ray system. Los Alamos National Laboratory, Los Alamos, NM: 

University of California. September 30. [SRDB Ref ID: 82245]
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 25 of 29

 

ORAUT [2014]. Medical dose to the B-lymphocytes. Oak Ridge, TN: Oak Ridge Associated 

Universities Team. ORAUT-RPRT-0064 Rev. 00, June 3. [SRDB Ref ID: 132772]

ORAUT [2017]. Occupational medical x-ray dose reconstruction. Oak Ridge, TN: Oak Ridge 

Associated Universities Team. ORAUT-PROC-0061 Rev. 04, May 6. [SRDB Ref ID: 166910]

ORAUT [2019]. Dose reconstruction from occupational medical x-ray procedures. Oak Ridge, TN: 

Oak Ridge Associated Universities Team. ORAUT-OTIB-0006 Rev. 06, September 27. [SRDB Ref ID: 

178310]

ORAUT [2022a]. LANL x-ray doses ORAU Team project spreadsheets. Oak Ridge, TN: Oak Ridge 

Associated Universities Team. March 31. [SRDB Ref ID: 192214] 

ORAUT [2022b]. LANL medical CLL parameters zip file. Oak Ridge, TN: Oak Ridge Associated 

Universities Team. August 31. [SRDB Ref ID: 192215]

Romero PG [2022]. LANL response to data request LANL FY21-006 for additional medical x-ray 

information. Los Alamos, NM. April 11 [SRDB Ref ID: 192485] 

Sebelius K [2010]. 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 Los Alamos National Laboratory (LANL) Los Alamos, New Mexico. Washington, DC: 

U.S. Department of Health and Human Services, Office of the Secretary. July 13. [SRDB Ref ID:

169472]

Sebelius K. [2012]. 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 Los Alamos National Laboratory (LANL) Los Alamos, New Mexico, Washington, DC: 

U.S. Department of Health and Human Services, Office of the Secretary. November 9. [SRDB Ref ID:

169473]

Shalkowski N, Richardson C, Schlapper J [1991]. Radiation protection survey of the HS-2 medical 

x-ray facility. Memorandum to W. Greendyke. Los Alamos National Laboratory, Los Alamos, NM: 

University of California. August 23. [SRDB Ref ID: 89088] 

Shipman TL [1949]. H-Division progress report, 20 December 1948 - 20 January 1949. Los Alamos 

Scientific Laboratory, Los Alamos, NM: University of California. February 10. [SRDB Ref ID: 188267] 

Shipman TL [1950a]. Health Division annual report. Los Alamos Scientific Laboratory, Los Alamos, 

NM: University of California. LA-1072, February 28. [SRDB Ref ID: 984]

Shipman TL [1950b]. H-Division progress report May 20, 1950 to June 20, 1950. Los Alamos 

Scientific Laboratory, Los Alamos, NM: University of California. [SRDB Ref ID: 188268] 

Shipman TL [1952]. H-Division progress report February 20 - March 20, 1952. Los Alamos Scientific 

Laboratory, Los Alamos, NM: University of California. April 8. [SRDB Ref ID: 188300] 

Shipman TL [1954]. Health Division annual report 1953. Los Alamos Scientific Laboratory, Los 

Alamos, NM: University of California. LA-1689, February 15. [SRDB Ref ID: 27942]

Shipman TL [1955]. Annual report of the Health Division, 1954. Los Alamos Scientific Laboratory, Los 

Alamos, NM: University of California. January. [SRDB Ref ID: 27939]
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 26 of 29

 

Shipman TL [1958]. Annual report of the Health Division 1957. Los Alamos Scientific Laboratory, Los 

Alamos, NM: University of California. LA-2216, October 17. [SRDB Ref ID: 27935]

Valentine A [1989]. Radiation protection quarterly report. Los Alamos National Laboratory, Los 

Alamos, NM: University of California. [SRDB Ref ID: 40772]

Velarde S [2009]. Annual x-ray protection survey. Memorandum to P. Cruz. Los Alamos National 

Laboratory, Los Alamos, NM: Los Alamos National Security. June 18. [SRDB Ref ID: 188301] 

Voelz GL, Dummer JE, Grier RS, Blackwell LA, Umbarger CJ, Jackson JO, Smith DR, Keenan TK, 

Hansen WR, Wilkinson GS [1981]. Health Division quarterly report July – September 1981. Los 

Alamos National Laboratory, Los Alamos, NM: University of California. [SRDB Ref ID: 76279]

Wade C, ed. [1991]. Health safety environment update, summary of 1990 quarterly reports, revised 

September 1991. Los Alamos National Laboratory, Los Alamos, NM: University of California. [SRDB 

Ref ID: 45709]
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GLOSSARY

air kerma in air

The sum of kinetic energy of all charged particles liberated per unit mass of air. The unit is the 

joule per kilogram and is given the special name gray.

beam quality

Empirical measure of the ability of a polyenergetic X-ray beam to penetrate matter affected by 

the kilovoltage, anode material, voltage waveform, and filtration of an X-ray tube. The 

half-value layer in millimeters of aluminum is a typical measure of X-ray beam quality for the 

energy range used in radiography. Also called beam hardness. See filtration. 

filtration

Process of filtering an X-ray beam, usually with millimeter thicknesses of aluminum material 

between the X-ray source and the film, that preferentially absorbs photons from the beam. 

Usually measured in equivalent millimeters of aluminum. See beam quality and half-value 

layer. 

gray (Gy)

International System unit of absorbed radiation dose, which is the amount of energy from any 

type of ionizing radiation deposited in any medium; 1 gray equals 1 joule per kilogram or 

100 rad. Gray is also the plural.

grid

Device that consists of a series of thin, closely spaced lead strips that is placed between the 

person being X-rayed and the X-ray film to reduce interaction of scattered radiation with the 

film.

half-value layer (HVL)

Thickness of a specified substance, usually specified in equivalent millimeters of aluminum, 

which, when introduced in the path of a given beam of radiation, reduces the kerma rate by 

one-half. See filtration. 

Interactive RadioEpidemiological Program (IREP)

Computer program that uses a person’s calculated annual organ doses and other information 

(e.g., gender, age at diagnosis, and age at exposure) to calculate the probability of causation 

of a specific cancer from a given pattern and level of radiation exposure.

kerma

Measure in units of absorbed dose (usually gray but sometimes rad) of the energy released by 

radiation from a given amount of a substance. Kerma is the sum of the initial kinetic energies 

of all the charged ionizing particles liberated by uncharged ionizing particles (neutrons and 

photons) per unit mass of a specified material. Free-in-air kerma refers to the amount of 

radiation at a location before adjustment for any external shielding from structures or terrain. 

The word derives from kinetic energy released per unit mass. 

lateral (LAT)

Orientation of the body during an X-ray procedure in which the X-rays pass from one side of 

the body to the other. 

organ dose

Dose to a given organ from a radiation exposure. 
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 28 of 29

photofluorography

Historical radiographic technique to produce chest images for screening a large number of 

people in a short period of time. The X-ray image produced on a fluorescent screen was 

photographed on 4- by 5-inch film. Photofluorography was the primary method of screening 

large populations for tuberculosis before the advent of nonradiographic screening methods. 

Also called fluorography or mass miniature radiography. Not to be confused with fluoroscopy.

posterior-anterior (PA)

Physical orientation of the body relative to a penetrating directional radiation field such that the 

radiation passes through the body from the back to the front.

preemployment X-ray

An X-ray, usually of the chest, taken before hire or assignment to a specific job. The purpose 

of preemployment X-rays was to screen for active disease such as tuberculosis.

rad

Traditional unit for expressing absorbed radiation dose, which is the amount of energy from 

any type of ionizing radiation deposited in any medium. A dose of 1 rad is equivalent to the 

absorption of 100 ergs per gram (0.01 joule per kilogram) of absorbing tissue. The rad has

been replaced by the gray in the International System of Units (100 rad = 1 gray). The word 

derives from radiation absorbed dose; rad is also the plural.

radiograph

Static images produced on radiographic film by gamma rays or X-rays after passing through 

matter. In the context of the Energy Employees Occupational Illness Compensation Program 

Act of 2000, radiographs are X-ray images of the various parts of the body used to screen for 

disease. See radiology.

radiology

Medical science and specialty of producing images on radiographic film or other media, which 

are used to identify, diagnose, and or treat diseases, injuries, or other conditions.

rem

Traditional unit of radiation dose equivalent that indicates the biological damage caused by 

radiation equivalent to that caused by 1 rad of high-penetration X-rays multiplied by a quality 

factor. The sievert is the International System unit; 1 rem equals 0.01 sievert. The word 

derives from roentgen equivalent in man; rem is also the plural.

screen

Fluorescent material in X-ray film cassettes that absorbs X-rays and converts them into light to 

expose the X-ray film. Also called intensifying screens.

source-to-image distance

Distance from the X-ray machine target (anode) to the plane of the image receptor (film). This 

distance is standardized for typical radiographic procedures. Chest X-rays, for example, are 

performed at a 72-inch source-to-image distance.

source-to-skin distance (SSD)

Distance from the X-ray machine target (anode) to the skin of the person being radiographed. 

This distance varies with the size of the person being radiographed.
Document No. ORAUT-TKBS-0010-3 Revision No. 02 Effective Date: 01/10/2023 Page 29 of 29

technique

Combination of X-ray machine settings (technique factors) used to produce radiographs, which 

consists of the kilovoltage, tube current (milliamperes), and exposure time (seconds). The last 

two parameters are often multiplied to yield the electric charge that has crossed the X-ray tube 

during the exposure in units of milliampere-seconds. Any combination of time and tube current 

that produces a given product in milliampere-seconds produces the same exposure for a fixed 

peak kilovoltage. Also called technic.

termination X-ray

X-ray, usually of the chest, taken when an employee separates from the company.

tube current

Average electrical current measured in milliamperes flowing from the cathode to the anode of 

an X-ray tube during operation of the tube.

X-ray

See radiograph.

X-ray tube

Evacuated electronic tube in which electrons are accelerated by an applied voltage to strike an 

anode or target and produce X-rays.