SEC Petition Evaluation Report 

Petition SEC-00033 

Report Rev # 1 Report Submittal Date 10-03-2006 

Subject Expert(s): LaVon B. Rutherford 

Site Expert(s): N/A 

Petition Administrative Summary 

Petition Under Evaluation 

Petition # Petition 

Type 

Qualification Date DOE/AWE Facility Name 

SEC-00033 83.13 October 6, 2005 Oak Ridge Institute of Nuclear Studies (ORINS) 

Initial Class Definition 

All Medical Division employees who worked at the Oak Ridge Institute of Nuclear Studies from June 1, 1950 through June 25, 1956. 

Proposed Class Definition 

Employees of the Department Of Energy (DOE) predecessor agencies and their contractors or subcontractors, who were monitored, or 

should have been monitored, while working at the Oak Ridge Institute of Nuclear Studies Cancer Research Hospital from May 15, 

1950, through December 31, 1963, and who were employed for a number of work days aggregating at least 250 work days, either 

solely under this employment or in combination with work days within the parameters (excluding aggregate work day parameters) 

established for other classes of employees included in the SEC. 

Related Petition Summary Information 

SEC Petition Tracking #(s) Petition Type DOE/AWE Facility Name Petition Status 

NONE 

Related Evaluation Report Information 

Report Title DOE/AWE Facility Name 

NONE 

Lead Technical Evaluator: [Signature on file] 

LaVon B. Rutherford 

10/04/06 

Date 

Peer Review Completed By: [Signature on file] 

James W. Neton 

10/04/06 

Date 

SEC Petition Evaluation Approved By: [Signature on file] 

Larry Elliott 

10/04/06 

Date 
SEC-00033 10-03-06 ORINS 

RECORD OF ISSUE/REVISIONS 

ISSUE 

AUTHORIZATION 

DATE 

REV. 

NO. DESCRIPTION 

7-20-2006 0 Document developed and issued to report the 

findings of the evaluation of SEC-00033, ORINS. 

10-04-2006 1 Revised to incorporate Department of Energy 

(DOE) predecessor agencies into the SEC class 

definition. 

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Evaluation Report Summary: SEC-00033, ORINS 

This evaluation report by the National Institute for Occupational Safety and Health (NIOSH) 

addresses a class of employees proposed for addition to the Special Exposure Cohort (SEC) per the 

Energy Employees Occupational Illness Compensation Program Act of 2000, as amended, 42 USC 

(EEOICPA) and 42 CFR 83, Procedures for Designating Classes of Employees as Members of the 

Special Exposure Cohort Under the Energy Employees Occupational Illness Compensation Program 

Act of 2000. 

Petitioner Requested Class Definition 

Petition SEC-00033, qualified on October 6, 2005, requested NIOSH to consider the following class: 

All Medical Division employees that worked at the Oak Ridge Institute of Nuclear Studies from June 

1, 1950 through June 25, 1956. 

NIOSH Proposed Class Definition 

This evaluation defines a single class of employees for which NIOSH cannot estimate radiation doses 

with sufficient accuracy. This class includes: Employees of the Department Of Energy (DOE) 

predecessor agencies and their contractors or subcontractors, who were monitored, or should have 

been monitored, while working at the Oak Ridge Institute of Nuclear Studies Cancer Research 

Hospital from May 15, 1950, through December 31, 1963, and who were employed for a number of 

work days aggregating at least 250 work days, either solely under this employment or in combination 

with work days within the parameters (excluding aggregate work day parameters) established for 

other classes of employees included in the SEC. 

Feasibility of Dose Reconstruction 

Per EEOICPA and 42 CFR § 83.13(c)(1), NIOSH has established that it does not have access to 

sufficient information to: (1) estimate either the maximum radiation dose incurred by any member of 

the class; or (2) estimate such radiation doses more precisely than a maximum dose estimate. The sum 

of information from the available resources is not sufficient to document or estimate the potential 

maximum internal exposure to members of the class under plausible circumstances during the period 

from May 15, 1950, through December 31, 1963. 

Health Endangerment 

Per EEOICPA and 42 CFR § 83.13(c)(3), NIOSH did not identify any evidence from the petitioners 

or from other resources that would establish that the class was exposed to radiation during a discrete 

incident likely to have involved exceptionally high level exposures. However, the evidence reviewed 

in this evaluation indicates that some workers in the class may have accumulated substantial chronic 

exposures from the inhalation and ingestion of radionuclides, combined with external exposures to 

gamma and beta radiation. Consequently, NIOSH has determined that health was endangered for 

those workers covered by this evaluation who were employed for a number of work days aggregating 

at least 250 work days within the parameters established for this class or in combination with work 

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

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Table of Contents 

Evaluation Report Summary: SEC-00033, ORINS................................................................................. 3 

1.0 Purpose and Scope.......................................................................................................................... 7 

2.0 Introduction .................................................................................................................................... 7 

3.0 Petitioner Requested Class/Basis and Class(es) Evaluated by NIOSH .......................................... 8 

4.0 Data Sources Reviewed by NIOSH................................................................................................ 9 

4.1 Site Profile Technical Basis Documents (TBDs) .................................................................. 9 

4.2 ORAU Technical Information Bulletins (OTIBs)................................................................. 9 

4.3 Facility Employees and Experts ............................................................................................ 9
 

4.4 Previous Dose Reconstructions ............................................................................................. 9
 

4.5 NIOSH Site Research Database .......................................................................................... 10 

4.6 PubMed Database ................................................................................................................ 10 

4.7 Documentation and/or Affidavits Provided by the Petitioners............................................ 11 

5.0 Radiological Operations Relevant to the Proposed Class ............................................................ 12 

5.1 ORINS Cancer Treatments and Process Descriptions......................................................... 12 

5.2.1 External Exposures .................................................................................................. 14 

5.2.2 Internal Exposures ................................................................................................... 15 

6.0 Summary of Available Monitoring Data for the Proposed Class ................................................. 17 

6.1 External Monitoring ............................................................................................................ 17 

6.2 Internal Monitoring ............................................................................................................. 18 

6.3 Air Sampling ....................................................................................................................... 18 

6.4 Source Term ........................................................................................................................ 19 

7.0 Feasibility of Dose Reconstruction for the Proposed Class ......................................................... 19 

7.1 Analysis of Data Sufficiency and Reliability ...................................................................... 20 

7.2 Internal Radiation Doses ..................................................................................................... 20 

7.3 External Radiation Doses .................................................................................................... 21 

7.4 Evaluation of Petition Basis for SEC-00033 ....................................................................... 22 

7.5 Summary of Feasibility Findings for Petition SEC-00033.................................................. 22 

8.0 Evaluation of Health Endangerment for Petition SEC-00033...................................................... 23 

9.0 NIOSH Proposed Class for Petition SEC-00033.......................................................................... 23 

10.0 References .................................................................................................................................... 25 

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Tables 

4-1: No. of ORINS Claims Submitted Under the Dose Reconstruction Rule ....................................... 10 

5-1: ORINS Medical Division Activities Timeline ............................................................................... 12 

5-2: Exposure of Selected Personnel Measured by Routine Film Badges Over a 3-Month Period ...... 14 

5-3: Exposure to Radioactivity during Surgical Operations (mr Total Exposure: Hands and Body) ... 15 

6-1: Summary of External Exposure Data Provided by ORAU ............................................................ 18 

6-2: Isotopes Used by the ORINS Medical Division in 1954 ............................................................... 19 

7-1: Summary of Feasibility Findings for SEC-00033.......................................................................... 22 

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SEC-00033 10-03-06 ORINS 

SEC Petition Evaluation Report for SEC-00033 

1.0 Purpose and Scope 

This report evaluates the feasibility of reconstructing doses for Oak Ridge Institute of Nuclear Studies 

(ORINS) employees at the ORINS Cancer Research Hospital in Oak Ridge, Tennessee, during the 

period from May 15, 1950, through December 31, 1963. It provides information and analyses 

germane to considering a petition for adding a class of employees to the congressionally-created SEC. 

This report does not provide any determinations concerning the feasibility of dose reconstruction that 

necessarily apply to any individual energy employee who might require a dose reconstruction from 

NIOSH. This report does not make the final determination as to whether or not the proposed class will 

be added to the SEC (see Section 2.0). 

This evaluation was conducted in accordance with the requirements of EEOICPA, 42 CFR 83, and the 

guidance contained in the Office of Compensation Analysis and Support’s Internal Procedures for the 

Evaluation of Special Exposure Cohort Petitions, OCAS-PR-004. 

2.0 Introduction 

The EEOICPA and 42 CFR 83 require NIOSH to evaluate qualified petitions requesting the 

Department of Health and Human Services (HHS) to add a class of employees to the SEC. The 

evaluation is intended to provide a fair, science-based determination of whether or not it is feasible to 

estimate with sufficient accuracy the radiation doses of the class of employees through NIOSH dose 

reconstructions.1 

42 CFR § 83.13(c)(1) states: Radiation doses can be estimated with sufficient accuracy if NIOSH has 

established that it has access to sufficient information to estimate the maximum radiation dose, for 

every type of cancer for which radiation doses are reconstructed, that could have been incurred in 

plausible circumstances by any member of the class, or if NIOSH has established that it has access to 

sufficient information to estimate the radiation doses of members of the class more precisely than an 

estimate of the maximum radiation dose. 

Under 42 CFR § 83.13(c)(3), if it is not feasible to estimate with sufficient accuracy radiation doses 

for members of the class, NIOSH must also make a determination whether or not there is a reasonable 

likelihood that such radiation doses may have endangered the health of members of the class. The 

regulation requires NIOSH to assume that any duration of unprotected exposure may have endangered 

the health of members of a class when it has been established that the class may have been exposed to 

radiation during a discrete incident likely to have involved levels of exposure similarly high to those 

occurring during nuclear criticality incidents. If the occurrence of such an exceptionally high level 

1

 NIOSH dose reconstructions under EEOICPA are performed using the methods promulgated under 42 C.F.R. pt. 82 and 

the detailed implementation guidelines available at www.cdc.gov/niosh/ocas. 

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exposure has not been established, then NIOSH is required to specify that health was endangered for 

those workers who were employed for at least 250 aggregated work days either solely under the 

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

classes (excluding aggregate work day requirements). 

NIOSH is required to document the evaluation in a report. For development of the evaluation report, 

NIOSH relies on its own dose reconstruction expertise, and typically, on technical support from Oak 

Ridge Associated Universities (ORAU). However, in this case, ORAU (formerly ORINS) has a 

conflict of interest issue and did not participate in this evaluation. Upon completion, the report is 

provided to the petitioners, the Advisory Board on Radiation and Worker Health, and the public. The 

Board will consider the NIOSH evaluation report, together with the petition, petitioner(s) comments, 

and other information the Board considers appropriate, to make recommendations to the Secretary of 

HHS on whether or not to add one or more classes of employees to the SEC. Once NIOSH has 

received and considered the advice of the Board, the Director of NIOSH will propose decisions on 

behalf of HHS. The Secretary of HHS will make final decisions, taking into account the NIOSH 

evaluation, the advice of the Board, and the proposed decisions and recommendations of the Director 

of NIOSH. Following this decision process, petitioners may seek a review of certain types of final 

decisions issued by the Secretary of HHS.2 

3.0 Petitioner Requested Class/Basis and Class(es) Evaluated by NIOSH 

Petition SEC-00033, as qualified on October 6, 2005, requested HHS to consider the addition to the 

SEC a class of all Medical Division employees at the ORINS from June 1, 1950, through June 25, 

1956. The petitioner asserted by affidavit that energy employees who meet the proposed class 

definition did not receive monitoring for potential internal radiation exposures. Records available to 

NIOSH support the petitioner’s statement that all such employees were not routinely monitored for 

internal exposures through bioassay or other in vivo means. NIOSH also concluded it was reasonable 

to assume that there was a potential for internal exposure based on the processes involved in 

preparing, administering, and disposing of radioactive materials for cancer research and treatment. 

Accordingly, the evidence provided by the petitioner qualified the petition for further consideration by 

NIOSH, the Board, and HHS. 

NIOSH modified the time period of the petitioner-requested class, for the purposes of this evaluation, 

to May 15, 1950, to December 31, 1963, because: (1) the first cancer patient was admitted to the 

facility on May 15, 1950; and (2) internal exposure monitoring records are not available for any years 

of operation up until 1964. 

2 See 42 C.F.R. pt. 83 for a full description of the procedures summarized here. Additional internal procedures are 

available at www.cdc.gov/niosh/ocas. 

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4.0 Data Sources Reviewed by NIOSH 

NIOSH identified and reviewed many data resources to determine the availability of information 

relevant to determining the feasibility of dose reconstruction for the class of employees covered by the 

petition. This included determining the availability of information on personal monitoring, area 

monitoring, hospital processes, and radiation source materials. The following sections summarize the 

resources identified and reviewed. 

4.1 Site Profile Technical Basis Documents (TBDs) 

NIOSH has not prepared a Site Profile to cover the ORINS Cancer Research Hospital. 

4.2 ORAU Technical Information Bulletins (OTIBs) 

An ORAU Technical Information Bulletin (OTIB) is a general working document that provides 

guidance concerning the preparation of dose reconstructions and particular sites or categories of sites. 

NIOSH reviewed the existing OTIBs describing the methods for dose reconstruction to consider their 

usefulness for reconstructing doses for members of the proposed SEC class. The following TIB was 

identified as having relevance to dose reconstructions for members of the class: 

•	 OTIB: Dose Reconstruction from Occupationally Related Diagnostic X-Ray Procedures; ORAUTOTIB-0006, Rev. 3, PC1; December 21, 2005 

4.3 Facility Employees and Experts 

NIOSH interviewed five workers who were employed at ORINS during the proposed class period or 

very close to the proposed class period. The workers consisted of two research scientists, two health 

physicists, and a nurse. Two of the workers are existing EEOICPA claimants. Although the 

claimants were interviewed as part of their dose reconstruction, they were interviewed again to 

address additional questions about the facility and potential exposures. 

4.4 Previous Dose Reconstructions 

NIOSH reviewed its dose reconstruction database, NIOSH OCAS Claims Tracking System (NOCTS), 

to identify dose reconstruction cases under EEOICPA that might provide information relevant to the 

petition evaluation. Table 4-1 provides a results summary of this review for the May 15, 1950, 

through December 31, 1963, time frame. 

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Table 4-1: No. of ORINS Claims Submitted Under the Dose Reconstruction Rule 

(May 15, 1950, through December 31, 1963) 

Description Totals 

Number of cases submitted for energy employees who meet the proposed class definition employment 

period criteria. 

11 

Number of dose reconstructions completed for energy employees who were employed by ORINS at the 

ORINS Cancer Research Hospital during the years identified in the proposed class definition. 

5 

Number of cases for which internal dosimetry records were obtained for ORINS employees at the 

ORINS Cancer Research Hospital for the identified years in the proposed class definition. 

0 

Number of cases for ORINS employees at the ORINS Cancer Research Hospital for which external 

dosimetry records were obtained for the identified years in the proposed class definition. 

8 

NIOSH reviewed each claim to determine whether internal and/or external personal monitoring 

records could be obtained for the employee. As indicated in Table 4-1, NIOSH has been able to 

obtain external monitoring records for the 11 cases that meet the class definition. No internal 

monitoring data were available from the claimants’ Department of Energy files. NIOSH also 

reviewed the interviews conducted with claimants for these cases to determine whether they had 

provided relevant information for dose reconstruction. The interviews provided some information that 

would be useful for dose reconstructions (i.e., work locations, hours worked, and hazards 

encountered) and identified conditions for which there would have been a potential for internal 

exposures. 

4.5 NIOSH Site Research Database 

The NIOSH site research database (SRDB) was reviewed for documents to support the evaluation of 

the proposed class. The database contained some useful information on external exposure rates, 

radiological controls, medical procedures using radiation-generating devices and radioisotopes 

injections, and other ORINS historical information. 

4.6 PubMed Database 

Radiological activities conducted at the ORINS Cancer Research Hospital were not typical of the 

weapons complex. The facility conducted research in nuclear medicine, particularly for the treatment 

of cancer. Therefore, NIOSH also searched nuclear medicine research literature for evaluations of 

occupational exposure hazards in nuclear medicine. 

NIOSH searched the PubMed database, a service of the U.S. National Library of Medicine, to identify 

reports on potential occupational exposures to medical personnel while preparing, administering, and 

disposing of radioisotopes administered for medical purposes. NIOSH obtained 13 relevant 

documents (See References: AMA-1951; MED-1950; Rad-1980; HP-1985; HP-2005; Chem-1980; 

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SEC-00033 10-03-06 ORINS 

HP-1999; NucMed-Jun2003; NucMed-May2003; Thyroid-1997; NucTech-2002; and HP-1962). 

These included a report providing ORINS-specific information concerning radioisotope hazards in 

medical applications. This report (AMA-1951) titled, Radioisotope Hazards and Protection in a 

Hospital, was authored by Dr. Marshall Brucer, head of the Medical Division of ORINS during the 

period covered by this evaluation. 

4.7 Documentation and/or Affidavits Provided by the Petitioners 

In qualifying and evaluating the petition, NIOSH reviewed the following documents submitted by the 

petitioners: 

•	 Petition Form B and supporting information provided with the petition; SECIS multi-document 

ID: 8830, received May 5, 2005. 

•	 ORINS historical information for 1950 though 1956; ORAU History section of the Oak Ridge 

Associated Universities (formerly ORINS) website (www.orau.org); SECIS multi-document ID: 

8830, received May 5, 2005. 

•	 Overview of ORINS nuclear medicine instrumentation (with photos); ORAU History section of 

the Oak Ridge Associated Universities (formerly ORINS) website (www.orau.org); SECIS multidocument ID: 8830, received May 5, 2005. 

•	 Provenance Form for Medical Sciences Division Human Radiation Experiments; SECIS multidocument ID: 8830, received May 5, 2005. 

•	 Information for Patients, brochure from the ORINS Medical Division; SECIS multi-document ID: 

8830, received May 5, 2005. 

•	 List of isotopes used by the Medical Division; SECIS multi-document ID: 8830, received May 5, 

2005. 

•	 Excerpts from book review of Plutonium Files by Eileen Welsome; SECIS multi-document ID: 

8830, received May 5, 2005. 

•	 Excerpts from the ACHRE Report; Atomic Energy Commission; SECIS multi-document ID: 

8830, received May 5, 2005. 

•	 Excerpts from Human Radiation Studies: Remembering the Early Years: Oral History of 

Oncologist Helen Vodopick, M.D.; SECIS multi-document ID: 8830, received May 5, 2005. 

•	 Notarized petitioner-proposed SEC class definition; SCE document ID: 9201; received August 26, 

2005. 

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5.0 Radiological Operations Relevant to the Proposed Class 

The following subsections summarize the radiological operations at the ORINS from May 15, 1950, 

through December 31, 1963, and the information available to NIOSH to characterize particular 

processes and radioactive source materials. From available sources, NIOSH has gathered the available 

process and source descriptions, information regarding the identity and quantities of each radionuclide 

of concern, information describing the process through which the radiation exposures of concern may 

have occurred, and information regarding the physical environment in which radiation exposures may 

have occurred. 

5.1 ORINS Cancer Treatments and Process Descriptions 

In January, 1949, the ORINS organized a Medical Division with the primary function of exploring the 

use of radioisotopes in the field of medicine (AMA-1951). Construction of the ORINS Cancer 

Research Hospital began on June 25, 1949. The 30-bed hospital and laboratory were completed in 

1950. The first patient was accepted for treatment on May 15, 1950 (ORAU 1949). 

The first patients accepted by the division were those afflicted with diseases for which the therapeutic 

use of radioisotopes was already generally established. The major focus of the Medical Division at 

that time was investigating new types of isotope treatment (ORAU 1949). 

During the early 1950s, ORINS Medical Division used a variety of cancer treatment methods 

involving the administration of various radioisotopes. Using the available ORINS annual reports from 

1952-1964 (ORINS-1952 – ORINS-1964), NIOSH has developed a timeline listing the activities 

conducted by the Medical Division for those years (Table 5-1). 

Table 5-1: ORINS Medical Division Activities Timeline 

Year Activities 

1950 • Radioiodine Treatment for thyroid cancer 

Note: NIOSH probably lacks complete information to identify activities for this year. 

1951 • Radioiodine Treatment for thyroid cancer 

Note: NIOSH probably lacks complete information to identify activities for this year. 

1952 • Radioiodine treatment for thyroid cancer 

• Cobalt-60 Teletherapy unit (200-curie source) 

• Gallium-67 and -72 ingestion for treatment of bone cancer 

• Administration of Gold-198 for palliation of advanced neoplasms 

1953 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• 800-curie cobalt-60 Irradiator (modified from 200-curie to 800-curie in July, 1952) 

1954 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

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Table 5-1: ORINS Medical Division Activities Timeline 

Year Activities 

1955 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

• Thyroid uptake calibration program using barium-133 and cesium-137 

1956 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

• Thyroid uptake calibration program continued using barium-133 and cesium-137 

• Portable strontium-barium X-ray source 

1957 • Same as 1956 

1958 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

• Thyroid uptake calibration program continued using barium-133 and cesium-137 

• Portable strontium-barium X-ray source 

• A leak occurred in the cobalt-60 Teletherapy unit. 

• The Medical Division began designing a whole body counter. 

• Medical Division evaluated the use of a radium source for treatment of carcinoma of the cervix. 

1959 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• Thyroid uptake calibration program continued using barium-133 and cesium-137 

• The Medical Division continued designing a whole body counter. 

• The total body irradiator was constructed and installed. The unit contained 8 – 500 curie cesium 

sources. 

1960 • A number of isotopes were administered internally, including: phosphorous-32, gold-198, yttrium-90, 

leutecium-177, iodine-131, and gallium-67. 

• Thyroid uptake calibration program continued using barium-133 and cesium-137 

• The Medical Division continued designing a whole body counter. The Division narrowed down to two 

types of detectors: a sodium iodide crystal and a “tank” detector system. 

• The total body irradiation facility was released for clinical operation in May, 1960. 

1961 • No annual report available. However, based on other documents it is reasonable to assume that all work 

occurring in 1960 continued in 1961. 

1962 • Teletherapy work continued with the cesium and cobalt sources. 

• The Medical Division continued work on a whole body counter. 

• A number of isotopes were administered internally, including: barium-133, chromium-51, phosphorous32, gold-198, yttrium-90, leutecium-177, iodine-125, -130, and -131, and iron-58 and -59. 

1963 • No annual report available. However, based on other documents it is reasonable to assume that all work 

occurring in 1962 continued in 1963. 

1964 • The Medical Division began its whole body counting program. 

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5.2 Radiological Exposure Sources 

ORINS recognized at the time that the potential for external occupational radiation exposures was 

most substantial, as evidenced by the radiological safety program instituted. Although there was also 

potential for substantial internal exposures arising from preparing, administering, and disposing of 

radioisotopes and radioactive waste, NIOSH found no evidence of personnel or workplace monitoring 

that could be used to bound internal radiation exposures The following sections summarize these 

external and internal exposure circumstances. 

5.2.1 External Exposures 

External exposures to Medical Division personnel were well documented. External exposures 

occurred through a variety of processes and circumstances associated with the use of radioactive 

medicines administered internally to patients, and with the radiation-generating devices used to 

provide treatments using an external radiation source. A good example of the actual external 

exposures received by various working classes of ORINS personnel is documented in the report, 

Radioisotope Hazards and Protection in a Hospital (AMA-1951). In that report, the ORINS Medical 

Division studies exposures to personnel over a three-month period. During the period, there was an 

average hospital load of 17 patients undergoing some type of radiation therapy. The isotopes brought 

in during that period were 3.98 curies of Ga72; 2.12 curies of Au198; 1.11 curies of I 131; .04 curies of 

P32; 0.02 curies Na24 . Table 5-2 was recreated from a table in that report. 

Table 5-2: Exposure of Selected Personnel Measured by Routine Film Badges Over a 3-Month Period 

(Dec. 1950 through Feb. 1951) 

Type of Work No. with 

Blank Badge 

No. Exposed Avg. mr/day Exposure Largest Avg. 

Exposure in 

Group (mr/day) 

Open Window Closed Window 

Staff (M.D. or Ph.D) 3 10 9.1 9.1 55.7 

Part-time Staff 1 3 2.0 3.9 10.9 

Technicians 2 9 10.3 11.9 28.5 

Nurses 0 12 4.9 3.9 10.6 

Nurse aids 0 6 4.1 3.7 5.9 

Orderlies 0 2 12.2 11.4 15.9 

Maids 0 2 1.8 1.8 3.1 

Maintenance Men 4 3 0.6 0.6 0.6 

Administrative 1 4 1.5 1.3 4.2 

Total Personnel 11 51 6.1 6.1 55.7 

As can be seen in Table 5-2, the highest average daily exposures were received by: the technicians 

who handled the urine, feces, blood, and tissue samples; the doctors and staff chemists who 

administered the radioactive medicines and prepared the medicines; and the orderlies who spent most 

of their time caring for the needs of the patients (AMA-1951). However, it is important to note that 

even the administrative staff received some daily exposures. 

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Another table presented in this report identifies external exposures to the surgeon, first assistant, and 

another assistant or anesthetist during five different surgical operations. This data is presented in 

Table 5-3 below: 

Table 5-3: Exposure to Radioactivity during Surgical Operations (mr Total Exposure: Hands and Body) 

(Dec. 1950 through Feb. 1951) 

Operation Surgeon First Assistant Assistant/Anesthetist 

Left 

Hand 

Right 

Hand 

Total 

Body 

Left 

Hand 

Right 

Hand 

Total 

Body 

Left 

Hand 

Right 

Hand 

Total 

Body 

Laparotomy Neg. Neg. 10 Neg. Neg. 10 ... ... 10 

Laparotomy 155 75 40 35 35 10 50 ... 10 

Laparotomy 490 180 80 290 600 80 30 ... 10 

Implant Radium 

Needles 

700 430 90 360 470 90 ... ... ... 

Autopsy 150 140 60 ... ... 35 ... ... ... 

Note: There was no legend for this table to explain the meaning for the abbreviation “Neg.” or for the ellipsis (...). In 

addition, the Laparotomy procedure was not defined. The Medical Dictionary by the Editors of the American 

Heritage Dictionaries defines Laparotomy as a surgical incision into the abdominal cavity through the loin or flank. 

From this table it is important to note the exposure to the hands compared to the whole body for these 

surgical procedures. The exposures to the hands were much higher than the total body. 

The Medical Division used radiation-generating devices capable of delivering high doses of radiation 

to patients, and in the process, potentially exposing employees. Staff used teletherapy units that 

employed strong gamma emitters such as cobalt-60 and cesium-137 with large activities (200-800 

curies) for the irradiation of cancerous organs, and for total body irradiations for leukemia treatment. 

5.2.2 Internal Exposures 

As indicated by the personnel interviewed during the evaluation, the ORINS Medical Division staff 

felt there was a low potential for significant internal exposure. This assumption was based on the 

short half lives of the isotopes used and the fact that these isotopes were used in liquid forms. 

However, NIOSH’s review of the documents in the SRDB and the documents obtained from the 

PubMed database identified a number of potential internal exposure scenarios at the ORINS Cancer 

Research Hospital. Although potential exposure scenarios would have differed depending on the 

radioisotopes involved, all scenarios would have shared the following common features: preparation 

of medicines containing radioisotopes for cancer treatment; administration of medicines to patients 

either orally or through injections; control and disposal of biological waste (e.g., urine, feces, 

cancerous organs and other contaminated waste); and exposure to, and control of, airborne 

contaminants created during spills of radioactive medicines and biological waste, especially iodine 

solutions. 

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These conclusions are corroborated by the following documented sources: 

•	 A 1950 memo discussing external exposure concerns (MED-1950) 

•	 Interview with a former ORINS Nurse employed during the class period (INT-2006) 

•	 Medical reports retrieved from the PubMed database (AMA-1951, Rad-1980, HP-1985, HP-2005, 

and Thyroid-1997) 

The 1950 memo (MED-1950) was written to identify the external exposure concerns from 

administering gallium to patients. However, the memo also identifies “associated problems” beyond 

the external exposure concerns. The first associated problem identified is general contamination of 

the facility: 

Due to the manual handling, type of instruments required and unpredictable patient reactions, 

among other causes, infrequent major spills and more frequent minor spills are likely to occur. 

It appears common sense, great care and experience will have to point out the solutions as the 

incidents occur. It is most likely some rooms will have to be evacuated while spills are cleaned 

and allowed to decay. Monitoring of eating utensils, dishwasher, etc., appears to be a 

necessity as cases have already been noted. 

The second associated problem identified is exposure to contaminated urine: 

Present samples are too contaminated for direct disposal in the sanitary sewer. They are 

being collected in bed pans for storage in one gallon jugs which are placed in an improvised 

shield for decay. They are eventually discharged into the hold up tanks provided. The room 

now used, which was not designed for the use, is practically filled and is also serving the 

purpose for which it was designed. Here again the probability of contamination due to 

spillage is high, although of much lower intensity than the original solution. This is likely to 

develop into a problem requiring additional facilities. 

The contamination problems identified above potentially exposed personnel to airborne contaminants 

that would lead to internal exposure. In addition, there was a potential for ingestion of radioactive 

contaminants from the contamination being spread to food, eating utensils, and other areas with a high 

potential for unprotected contact. 

The issue of spills and the potential for internal exposures was discussed with a former ORINS nurse 

who worked during the class period. The nurse indicated that they tried to prevent spills, but they did 

occur. This nurse was contaminated and scrubbed down from a spill of contaminated urine. 

In addition to the internal exposure potential associated with radiological incidents and provisional 

radiological safety procedures, potential internal exposure to radioiodine is a particular concern. 

During the period covered by this evaluation, medical practitioners did not recognize that radioiodine 

creates an airborne internal exposure hazard, which has since been widely documented (NCRP-1996, 

Rad-1980, HP-1985, HP-2005, and Thyroid-1997). NCRP Report No. 124 states: 

Radioactive iodine has been noted for its volatility and therefore its potential for causing 

internal radiation dose in nuclear medicine personnel. Early (1987) and Miller (1979) 

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reported that two to three percent of the liquid 131I activity escaped when the cap of the bottle 

of liquid oral solution was removed as compared to 0.01 percent of the activity lost for iodine 

in the capsular form... 

One of the PubMed reports evaluated iodine levels in the thyroid glands of all staff categories in a 

hospital laboratory (HP-1985). The highest level of iodine in this study, 40 microcuries, was found in 

the chemist who prepared the solutions. Another study found iodine activity in the thyroid gland in 

persons handling therapeutic doses of iodine-131 as high as 170-180 nCi when measured 24 hours 

later (Rad-1980). Although this does not present a significant dose for a single uptake, the dose will 

add up if chronically exposed. In addition, NIOSH does not have information to compare the levels of 

therapeutic doses in this study, in 1979, to those used at ORINS in the 1950s. 

As indicated in Section 5.1, iodine-131 was used from the onset of ORINS Medical Division 

operations. The Division used iodine-125, -130, and -131 during the years identified in the proposed 

class description. Iodine-125 and -130 were used in the late1950s. 

6.0 Summary of Available Monitoring Data for the Proposed Class 

NIOSH reviewed the databases indicated in Section 4.0 for internal and external monitoring data. 

This includes personal monitoring data (e.g., film badges, TLDs, bioassays) and area monitoring data. 

NIOSH also attempted to gather data to support source term development. 

6.1 External Monitoring 

NIOSH’s review of the claimant files in NOCTS showed that of the 11 claimants meeting the class 

definition, eight of them had film badge monitoring data. The data submitted to DOE for the 

EEOICPA program were either cards containing the external deep dose or the information transferred 

from the card to a table. The DOE records indicate that ORINS used the TLD-100 until 1999, and 

during the class period, the film was calibrated using radium as the source. One report (AMA-1951) 

indicated a weekly badge exchange, but that may have been for the study indicated. Most of the 

records received by NIOSH are annual summaries of external exposure. However, some of the 

records are monthly reads of the film badge. It appears from these records that a monthly read was the 

standard practice. 

A request was made to ORAU (formerly ORINS) for additional external exposure data for ORINS 

employees within the class period. ORAU provided a spreadsheet with external monitoring data for 

ORINS employees from 1950-1961. The spreadsheet addressed external exposures to 504 ORINS 

employees. The external exposures provided by the DOE for the existing eight claimants with 

external dosimetry records were compared to the ORAU-provided spreadsheet; all of the numbers in 

the database matched the numbers provided by DOE. The external exposures listed in the spreadsheet 

were all deep dose. Table 6-1 was developed from the information in the spreadsheet. 

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Table 6-1: Summary of External Exposure Data Provided by ORAU 

Year No. Employees 

Monitored 

Lowest dose recorded 

(mrem) 

Mean dose recorded 

(mrem) 

Highest dose recorded 

(mrem) 

1950 83 30 526 7051 

1951 144 30 554 7310 

1952 135 30 272 1090 

1953 116 30 280 2675 

1954 104 30 371 3901 

1955 114 30 350 2330 

1956 149 30 191 1210 

1957 138 30 256 2305 

1958 148 30 322 1360 

1959 158 30 295 2215 

1960 163 30 299 1355 

1961 155 30 336 2845 

Although beta emitters were used in a few applications during cancer research, it appears that Medical 

Division personnel would have had limited exposure to beta radiation. Based on interviews and the 

report, Radioisotope Hazards and Protection in a Hospital (AMA-1951), surgical gloves and other 

protective clothing would have limited the beta exposure to medical personnel. Additionally, that 

report includes a table that was recreated in Section 5.2.1 as Table 5-2. Table 5-2 provides support for 

the conclusion that there was a limited potential for beta exposure. The table includes exposures 

(open and closed window) to personnel in various job classifications over a three-month period. The 

open and closed window readings were very close to a 1:1 ratio. 

The documents retrieved from the SRDB also were reviewed for external monitoring data. Dose rate 

information was found for a patient injected with 20 millicuries of gallium-67 (MED-1950) and area 

dose rate information for multiple injections occurring at the same time in the hospital. 

6.2 Internal Monitoring 

NIOSH has searched the data resources listed in Section 4.0 of this report and has not located any 

internal monitoring data for ORINS employees at the ORINS Cancer Research Hospital during the 

1950-1963 period. This outcome is consistent with the reports of ORINS employees who have 

asserted there was no internal monitoring program during this period. Whole body monitoring data is 

available starting in 1964. 

6.3 Air Sampling 

NIOSH has searched the data resources listed in Section 4.0 of this report and has not located any air 

sampling data for ORINS Cancer Research Hospital during the 1950-1963 period. Again, the results 

of this data search are consistent with the reports of former employees. 

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6.4 Source Term 

NIOSH reviewed available data sources for source term information. The SRDB contains ORINS 

annual reports for 1952-1959, 1962, 1963, and 1964. In 1953, 1954, 1962, and 1963 the reports listed 

isotopes and the amount of activity in millicuries used by the Medical Division for the year. For 

example, Table 6-1 identifies the isotopes and activity used by the Medical Division in 1954. This 

information was taken from the annual report titled, Eighth Annual Report of the Oak Ridge Institute 

of Nuclear Studies, dated June 30, 1954 (ORINS-1954). 

Table 6-2: Isotopes Used by the ORINS Medical Division in 1954 

Isotope Activity (Millicuries) 

antimony-121, 124 225 

calcium-45 7 

cesium-134 10 

chromium-51 8 

europium-152, 154 1.5 

gallium-67 2587.4 

gold-198 8275 

holmium-166 64.3 

iron-59 3.65 

iodine-131 1350 

lutecium-177 192 

phosphorus-32 472 

potassium-42 390 

rubidium-86 145 

sodium-24 12 

sulfur-35 2 

yttrium-90 82.6 

yttrium-91 40 

cobalt-60 275 Milligrams 

7.0 Feasibility of Dose Reconstruction for the Proposed Class 

The feasibility determination for the class of employees covered by this evaluation report is governed 

by EEOICPA and 42 C.F.R. § 83.13(c)(1). Under this Act and rule, NIOSH must establish whether or 

not it has access to sufficient information to either estimate the maximum radiation dose for every 

type of cancer for which radiation doses are reconstructed that could have been incurred under 

plausible circumstances by any member of the class, or to estimate the radiation doses of members of 

the class more precisely than a maximum dose estimate. If NIOSH were to have access to sufficient 

information for either case, then it would be determined that it was feasible to conduct dose 

reconstructions. 

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In making determinations of feasibility, NIOSH begins by evaluating whether current or completed 

NIOSH dose reconstructions demonstrate the feasibility of estimating with sufficient accuracy the 

potential radiation exposures of the class (presented in Section 7.5 of this report). In addition, NIOSH 

systematically evaluates the sufficiency of different types of monitoring data, process and source term 

data, which together or individually might assure NIOSH can estimate either the maximum doses that 

members of the class might have incurred, or more precise quantities that reflect the variability of 

exposures experienced by groups or individual members of the class. This approach is specified in the 

SEC Petition Evaluation Internal Procedures (OCAS-PR-004) available at www.cdc.gov/niosh/ocas. 

Utilizing available personal and process monitoring data (see Section 5.0) to calculate maximum, 

claimant-favorable potential radiation doses for unmonitored employees is appropriate and possible 

only if the data are of sufficient quality. In addition to determining appropriate sampling, 

measurement, and analytical techniques, data quality sufficiency is dependant upon confidence that 

the selection of monitoring locations and personnel were appropriate and included the highest 

exposure locations and activities throughout the evaluated time frame. Similarly, it is important to 

determine that exposure potential associated with activities that were not associated with cancer 

treatment (e.g., research and development) were also evaluated. 

Results of the evaluation efforts focused on historical personnel monitoring selection are presented in 

Section 7.1. Evaluations examining (separately) the availability of information necessary for 

reconstructing internal and external radiation doses of members of the class follow in Sections 7.2 and 

7.3. 

7.1 Analysis of Data Sufficiency and Reliability 

Performing internal and external dose reconstructions requires worker monitoring data or source term 

and process information. Worker monitoring data includes data from members of the proposed class 

as well as data from workers outside the proposed class who were performing jobs with higher 

exposure potentials. Using co-worker monitoring data provides a means of calculating claimantfavorable and maximum potential radiation doses for class members who were unmonitored or have 

gaps in their monitoring records. 

In the case of this evaluation, NIOSH has found that the internal monitoring data and source term are 

insufficient for estimating internal radiation doses with sufficient accuracy for members of the 

proposed class. Therefore, further evaluation of the pedigree of any of the data was not performed. 

7.2 Internal Radiation Doses 

The principal source of internal radiation doses for members of the proposed class would have been 

inhalation and ingestion of radiological contaminants during the following activities: (1) preparation 

of medicines containing radioisotopes for cancer treatment; (2) administration of medicines to patients 

either orally or through injections; (3) control and disposal of biological waste (e.g., urine, feces, 

cancerous organs and other contaminated waste); and (4) exposure to, and control of, airborne 

contaminants created during spills of radioactive medicines, especially iodine solutions. 

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As indicated in Section 6.2, there are not any internal monitoring data from the onset of operations in 

1950 to 1964 when the whole body counter was installed. Internal monitoring data would allow direct 

reconstruction of an individual claimant’s internal dose. Also, there are not any air monitoring data 

that could be used for an internal exposure model. Lacking these data, NIOSH considered the 

sufficiency of source term and process data for developing an internal exposure model for the ORINS 

employees covered by this evaluation. As indicated in Section 6.4, there are some source term data 

for 1953, 1954, 1962, and 1963. In addition to the annual source term information, source term 

information for specific cancer applications is available from 1964 through the end of operations. 

This information gives activities associated with each application, which allows a more detailed dose 

model to be developed. 

Even though NIOSH has annual source term data for 1953, 1954, 1962, and 1963, there is no 

information defining how much activity of each isotope was used in each cancer treatment. Nor is 

there information as to how each isotope was administered. In lieu of bioassay data, this information 

is necessary to develop an exposure model with sufficient accuracy. There are indications that more 

information may be available, but at this time, NIOSH has been unable to obtain this information. 

As a result of these limitations, NIOSH cannot establish a maximum internal exposure scenario that 

addresses all of the internal exposure potential for the petitioning class, and therefore, cannot estimate 

internal doses for members of this class with sufficient accuracy. 

7.3 External Radiation Doses 

The principal source of external radiation doses for members of the proposed class would have been 

due to exposures to photon (gamma) radiation. Photon exposures occurred from: (1) radioactive 

cocktails prepared and administered to patients; (2) removal and disposal of cancerous organs 

containing activities of radioisotopes; (3) care of patients containing activities of radioisotopes; and 

(4) radiation-generating devices used in cancer research. 

Film badges were worn by all personnel from the onset of ORINS operations, including secretaries 

and janitors, as well as patient visitors, (AMA-1951). As indicated in Section 6.0, NIOSH’s review of 

the claimant files in NOCTS showed that of the eleven claimants meeting the class definition, eight 

had film badge monitoring data. In addition, ORAU provided a spreadsheet with external monitoring 

data for ORINS employees from 1950-1961. The spreadsheet addressed external exposures to 504 

ORINS employees. The data from the eight claimants with external exposure records was compared 

to this table and all eight claimants exposures matched. 

If NIOSH has indication through CATIs or other reports that personnel may have had skin 

contamination, NIOSH will use computer programs like VARSKIN and other computer models to 

address the dose to the skin and other organs from skin contamination. Because the majority of the 

dose is from gamma exposure, a dose from a skin contamination to the body will be accounted for by 

the film badge, and any dose from a skin contamination to the extremities can be bounded by the 

extremity dose estimated from surgical procedures. 

NIOSH finds that the available external monitoring data should be sufficient to reconstruct the 

external doses of all members of the proposed class. 

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SEC-00033 10-03-06 ORINS 

ORINS Cancer Research Hospital Occupational X-ray Examinations 

As revealed in the NIOSH review of the current individual claims and the SRDB, very little 

information exists concerning medical X-rays at ORINS during the class period. Based on one of the 

claims, chest X-rays were performed for routine physicals. However, the periodicity of X-rays is not 

clear; additional interviews may provide more detailed information concerning this issue. Once these 

interviews are complete, a reasonable periodicity can be identified. Using the identified periodicity, 

an upper bound for exposure for occupational medical X-rays can be established using the procedure, 

Occupational X-Ray Dose Reconstruction for DOE Sites (ORAUT-PROC-0061). 

In summary, NIOSH can reconstruct the medical X-ray dose for the class of ORINS workers in the 

class defined in this evaluation report with sufficient accuracy. 

7.4 Evaluation of Petition Basis for SEC-00033 

The petition basis provided in SEC-00033 was that there was no internal monitoring of personnel 

from June 1, 1950, to June 25, 1956. 

Personal monitoring, area monitoring, or co-worker monitoring are not always required in order to 

develop an exposure model for a given facility. However, if these are not available, NIOSH must 

have access to source term information and detailed process information in order to develop a 

sufficiently accurate exposure model. NIOSH has some source term information for 1953, 1954, 

1962, and 1963, but not enough source term or process information to develop a sufficiently accurate 

model for all of the radionuclides used in the cancer research facility. Therefore, NIOSH concludes 

there is insufficient information to reconstruct internal doses with sufficient accuracy and that the 

petition basis has been supported. 

7.5 Summary of Feasibility Findings for Petition SEC-00033 

This report evaluated the feasibility for completing dose reconstructions for Medical Division 

employees at ORINS from May 15, 1950, through December 31, 1963. NIOSH found that the 

monitoring records, process descriptions, and source term data available are not sufficient to perform 

complete dose reconstructions for the proposed class of employees. Specifically, NIOSH has 

determined that data to support reconstruction of internal dose does not exist. However, NIOSH has 

determined that external dose and medical x-ray dose can be reconstructed with sufficient accuracy. 

Table 7-1 summarizes the results of the feasibility findings at Site Name for each exposure source for 

the time period May 15, 1950 through December 31, 1963. 

Table 7-1: Summary of Feasibility Findings for SEC-00033 

Source of Exposure Reconstruction Feasible Reconstruction Not Feasible 

Internal X 

External X 

Occupational Medical X-ray X 

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8.0 Evaluation of Health Endangerment for Petition SEC-00033 

The health endangerment determination for the class of employees covered by this evaluation report is 

governed by EEOICPA and 42 CFR § 83.13(c)(3). Under these requirements, if it is not feasible to 

estimate with sufficient accuracy radiation doses for members of the class, NIOSH must also 

determine that there is a reasonable likelihood that such radiation doses may have endangered the 

health of members of the class. The regulation requires NIOSH to assume that any duration of 

unprotected exposure may have endangered the health of members of a class when it has been 

established that the class may have been exposed to radiation during a discrete incident likely to have 

involved levels of exposure similarly high to those occurring during nuclear criticality incidents. If the 

occurrence of such an exceptionally high level exposure has not been established, then NIOSH is 

required to specify that health was endangered for those workers who were employed for a number of 

work days aggregating at least 250 work days within the parameters established for the class or in 

combination with work days within the parameters established for one or more other classes of 

employees in the SEC. 

This NIOSH evaluation did not identify any evidence from the petitioners or from other resources that 

would establish that the class was exposed to radiation during a discrete incident or similar conditions 

resulting from the failure of radiation exposure controls and likely to have produced levels of 

exposure similarly high to those occurring during nuclear criticality incidents. NIOSH is not aware of 

any report of such an occurrence at the facility during this period. NIOSH finds the primary radiation 

exposure hazards to employees resulted from chronic exposures from the inhalation and ingestion of 

radionuclides, combined with external exposures to gamma and beta radiation. Consequently, NIOSH 

is specifying that health was endangered for those workers covered by this evaluation who were 

employed for a number of work days aggregating at least 250 work days within the parameters 

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

or more other classes of employees in the SEC. 

9.0 NIOSH Proposed Class for Petition SEC-00033 

This evaluation defines a single class of employees for which NIOSH cannot estimate radiation doses 

with sufficient accuracy. This class includes: Employees of the Department Of Energy (DOE) 

predecessor agencies and their contractors or subcontractors, who were monitored, or should have 

been monitored, while working at the Oak Ridge Institute of Nuclear Studies Cancer Research 

Hospital from May 15, 1950, through December 31, 1963, and who were employed for a number of 

work days aggregating at least 250 work days, either solely under this employment or in combination 

with work days within the parameters (excluding aggregate work day parameters) established for 

other classes of employees included in the SEC. 

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10.0 References 

AMA-1951, Radioisotope Hazards and Protection in a Hospital, Marshall Brucer, M.D.; Journal of 

the American Medical Association; December, 1951 

Chem-1980, Advantages of Using Thin Sodium Iodide Detectors for Thyroid Monitoring of Personnel 

Working with 125I , Clinical Chemistry; January, 1980 

HP-1962, A Summary of Radiation Exposures Received by Workers in Medical X-ray Departments 

from 1950-1960, Health Physics; March 1962 

HP-1985, Thyroid Burdens of 125I in Laboratory Workers, Health Physics; June, 1985 

HP-2005, A Case Study of the Estimation of Occupational Internal Dose using Urinary Excretion 

Data Obtained in a Biomedical Research Facility, Health Physics; December, 2005 

HP-1999, Experiences with High Dose Radiopeptide Therapy: The Health Physics Perspective, 

Health Physics; March, 1999 

INT-2006, Interview with former ORINS nurse; SECIS document ID: 2004 5/19/2006 (Non-submitter 

communication) 

MED-1950, ORINS Medical Center Radiation Problem; Office Memorandum – United States 

Government; August 15, 1950; Oak Ridge Associated Universities; Oak Ridge, TN 

NCRP-1996, NCRP Report No. 124, Sources and Magnitude of Occupational and Public Exposures 

from Nuclear Medicine Procedures, NCRP; March 1996 

NucMed–Jun2003, Safe Radiation Exposure of Medical Personnel by using Simple Methods of 

Radioprotection while Administering 131I-Lipiodol Therapy for Hepatocellular Carcinoma, Nuclear 

Medicine Communications; June 2003 

NucMed-May2003, Is it Safe to Work with Iodine-131 if You are Pregnant? A Risk assessment for 

Nuclear Medicine Staff Involved with Cleaning and Decontamination, Nuclear Medicine 

Communications; May 2003 

NucTech-2002, Measuring and Minimizing the Radiation Dose to Nuclear Medicine Technologists, 

Journal of Nuclear Medicine Technology; March 2002 

OCAS-PR-004, Internal Procedures for the Evaluation of Special Exposure Cohort Petitions, Rev. 0, 

National Institute for Occupational Safety and Health (NIOSH); Cincinnati, Ohio; September 23, 

ORAU-1949, Oak Ridge Associated Universities website, http://www.orau.org/visitor/history/ 

chronology/1949.htm 

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ORAU-1950, Oak Ridge Associated Universities website, http://www.orau.org/visitor/history/ 

chronology/1950.htm 

ORAUT-OTIB-0006, Dose Reconstruction from Occupationally Related Diagnostic X-Ray 

Procedures; Rev. 3, PC1; December 21, 2005 

ORAUT-PROC-0061, Occupational X-Ray Dose Reconstruction for DOE Sites; Rev. 00, December 

1, 2004 

ORINS-1952, Sixth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1952; Oak 

Ridge Associated Universities; Oak Ridge, TN 

ORINS-1953, Seventh Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1953; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1954, Eighth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1954; Oak 

Ridge Associated Universities; Oak Ridge, TN 

ORINS-1955, Ninth Annual Report of the Oak Ridge Institute of Nuclear Studies, June 30, 1955; Oak 

Ridge Associated Universities; Oak Ridge, TN 

ORINS-1956, Tenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1956; Oak 

Ridge Associated Universities; Oak Ridge, TN 

ORINS-1957, Eleventh Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1957; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1958, Twelfth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1958; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1959, Thirteenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1959; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1960, Fourteenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1960; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1962, Sixteenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1962; 

Oak Ridge Associated Universities; Oak Ridge, TN 

ORINS-1963, Seventeenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 

1963; Oak Ridge Associated Universities; Oak Ridge, TN 

Rad-1980, Internal Contamination of Laboratory Personnel by 131I, Radiology (journal); December, 

Thyroid-1997, Regulations for Radioiodine Therapy in the United States: Current Status and the 

Process of Change, Thyroid; April 1997 

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1980