ORAU TEAM 

Dose Reconstruction 

Project for NIOSH 

Oak Ridge Associated Universities I Dade Moeller I MJW Technical Services 

Page 1 of 23 

DOE Review Release 12/14/2009 

Document Title: 

Savannah River Site – Occupational Medical Dose 

Document Number: ORAUT-TKBS-0003-3 

Revision: 04 

Effective Date: 11/30/2009 

Type of Document: TBD 

Supersedes: Revision 03 Occupational 

Medical Dose Section 

Subject Expert(s): Elyse M. Thomas 

Site Expert(s): NA 

Approval: Signature on File Approval Date: 11/16/2009 

Edward D. Scalsky, Document Owner 

Concurrence: Signature on File Concurrence Date: 11/17/2009 

John M. Byrne, Objective 1 Manager 

Concurrence: Keith A. McCartney Signature on File for Concurrence Date: 11/23/2009 

Edward F. Maher, Objective 3 Manager 

Concurrence: Signature on File Concurrence Date: 11/18/2009 

Kate Kimpan, Project Director 

Approval: Signature on File Approval Date: 11/30/2009 

James W. Neton, Associate Director for Science

 New Total Rewrite Revision Page Change 

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

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION. 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 2 of 23 

PUBLICATION RECORD
 

EFFECTIVE 

DATE 

REVISION 

NUMBER DESCRIPTION 

07/15/2003 00 First Approved Issue. Incorporates formal internal and NIOSH 

review comments. Initiated by Edward D. Scalsky. 

08/21/2003 01 Approved issue of Revision 01. Incorporates formal internal and 

NIOSH review comments. Initiated by Edward D. Scalsky. 

10/29/2004 02 Approved issue of Revision 02. Revised to incorporate medical X-ray 

changes and added section on photofluorography. Incorporates 

formal internal and NIOSH review comments. Initiated by Edward D. 

Scalsky. 

04/05/2005 03 Approved issue of Revision 03. Incorporates formal internal and 

NIOSH review comments. Initiated by Edward D. Scalsky. 

11/30/2009 04 Approved revision to separate the site profile into an Introduction and 

five TBDs. This revision is updated with newly acquired captured 

information. Includes Attributions and Annotations section. Specific 

changes are as follows: Added specific technique factors for PA and 

LAT projections for Type I machines and for LAT projections for 

Types II through IV machines in Table 3-3. Added Table 3-4. 

Rearranged the various sections and changed section headings: 

Section 3.3.1 changed from X-ray Apparatus to Photofluorography; 

Section 3.3.2 from Collimation to Radiography; Moved the existing 

section 3.4.2 on Collimation to Section 3.4. Added Section 3.3.3. 

Replaced the text in the existing Section 3.5 that contained example 

calculations of doses for the various projection types with two 

paragraphs of new text describing how doses were assigned. The 

original Table B.2 is now Table 3.9. All organ doses for the period 

1950-1970 for Type I X-ray equipment have decreased; also doses 

for the male lungs and female bone marrow have been added. 

Entrance air kerma and skin doses for the PA and LAT projections 

have been deleted from Table 3-9. Table 3-10 and Table 3-11 have 

been added. The discussion regarding the four potential sources of 

uncertainty has been deleted except for the final statement to assume 

a +30% uncertainty at the 99% confidence level as stated in OTIB0006. Changed reported range on technique factors for the Picker 

machine. Values added to Table 3-3; The calculated entrance and 

exit skin doses were compared to the measured entrance and exit 

skin doses of Cooley (Cooley, 1967) made on the mobile Picker 

machine for the PA chest for the 1950-1970 time period. The 

comparison is shown in Table 3-7. The 21% uncertainty derived from 

the Cooley measurements is substituted into the root mean square 

calculation for combined uncertainty instead of the 10% value initially 

reported from this source of uncertainty in ORAUT-OTIB 0006 (2005). 

As a result of this substitution, the resulting combined, standard 

uncertainty is 34%, and rounded up to 35%. Skin doses were put into 

a different table format to more closely match the skin dose tools. 

Incorporates formal internal and NIOSH review comments. 

Constitutes a total rewrite of the document. Training required: As 

determined by the Objective Manager. Initiated by Edward D. 

Scalsky and Elyse M. Thomas. 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 3 of 23 

TABLE OF CONTENTS
 

SECTION TITLE PAGE 

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

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

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

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

3.2 Examination Frequencies .......................................................................................................... 7
 

3.3 Equipment and Techniques ....................................................................................................... 7
 

3.3.1 Photofluorography...........................................................................................................7
 

3.3.2 Radiography.................................................................................................................... 9
 

3.3.3 Technique Factors ..........................................................................................................9
 

3.4 Organ Dose Calculations ......................................................................................................... 11
 

3.5 Uncertainty............................................................................................................................... 19
 

3.6 Attributions and Annotations .................................................................................................... 20
 

References ........................................................................................................................................... 21
 

LIST OF TABLES 

TABLE TITLE PAGE 

3-1 Frequency of chest X-ray screening ........................................................................................8
 

3-2 Description of X-ray and ancillary equipment ..........................................................................9
 

3-3 Technique factors for each type of X-ray equipment .............................................................10
 

3-4 Entrance kerma in air for projections .....................................................................................11
 

3-5 ICRP reference organs use for IREP organs without unique ICRP 34 dose 

conversion factors for properly collimated chest radiography ................................................12
 

3-6 Substitute DCFs for dose to certain organs from poorly collimated chest Xray beams before 1970 .......................................................................................................... 12
 

3-7 Comparison of calculated and measured entrance and exit skin doses for 

Type 1 X-ray equipment ........................................................................................................13
 

3-8 Organ doses from PFG, 1951 to 1960 ...................................................................................13
 

3-9 ICRP Publication 34 DCFs from PA and LAT radiographic chest procedures .......................14
 

3-10 Organ doses from PA and LAT chest X-rays at SRS ............................................................15
 

3-11 Skin dose guidance for various chest projections and time periods ......................................15
 

3-12 Dose in rem to various areas of skin from PA and LAT chest X-rays ....................................18
 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 4 of 23 

ACRONYMS AND ABBREVIATIONS
 

AP anterior-posterior 

C.F.R. Code of Federal Regulations 

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 

Gy gray 

HVL half-value layer 

ICRP International Commission on Radiological Protection 

in. inch 

IREP Interactive RadioEpidemiological Program 

kVp kilovolts-peak, applied kilovoltage 

LAT lateral 

mA milliampere 

mAs milliampere-second 

mGy milligray 

mm millimeter 

NCRP National Council on Radiation Protection and Measurements 

NIOSH National Institute for Occupational Safety and Health 

ORAU Oak Ridge Associated Universities 

PA posterior-anterior 

PFG photofluorography 

POC probability of causation 

R roentgen 

s second 

SID source-to-image distance 

SRDB Ref ID Site Research Database Reference Identification (number) 

SRP Savannah River Plant 

SRS Savannah River Site 

SSD source-to-skin distance 

TBD technical basis document 

U.S.C. United States Code 

USFS U.S. Forest Service 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 5 of 23 

WSI Wackenhut Services, Inc. 

§ section or sections 
 

3.1 

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INTRODUCTION 

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

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

documents that provide historic background information and guidance to assist in the preparation of 

dose reconstructions at particular sites or categories of sites. They will be revised in the event 

additional relevant information is obtained about the affected site(s). These documents may be used 

to assist NIOSH staff in the completion of the individual work required for each dose reconstruction. 

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

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

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

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

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

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

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

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

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

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

facility encompassed by EEOICPA. 

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

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

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

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

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

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

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

determined in accordance with the POC [probability of causation1

] guidelines established under 

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

guidelines (nor the dose reconstruction regulation, 42 C.F.R. Pt. 82) define “performance of duty” for 

DOE employees with a covered cancer or restrict the “duty” to nuclear weapons work (NIOSH 2007). 

The statute also includes a definition of a DOE facility that excludes “buildings, structures, premises, 

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

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

definition excludes Naval Nuclear Propulsion Facilities from being covered under the Act, the section 

of EEOICPA that deals with the compensation decision for covered employees with cancer [i.e., 42 

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

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

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

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

external occupational radiation exposures are considered valid for inclusion in a dose reconstruction. 

No efforts are made to determine the eligibility of any fraction of total measured exposure for inclusion 

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

occupationally derived (NIOSH 2007): 

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

conventional structures. 

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

reasons. 

1 The U.S. Department of Labor (DOL) is ultimately responsible under the EEOICPA for determining the POC. 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 7 of 23 

3.1.1 Purpose 

The purpose of this technical basis document (TBD) is to describe the occupational medical dose 

workers might have received at the Savannah River Site (SRS; formerly the Savannah River Plant 

(SRP)). Occupational medical dose results from X-ray procedures that were performed for health 

screening of energy employees during preemployment and annual physical examinations. X-rays that 

were taken as a result of on- or off-the-job injuries are not eligible for inclusion in dose reconstruction 

under EEOICPA. This TBD contains the technical information that will be used by the Oak Ridge 

Associated Universities (ORAU) Team to evaluate the dose workers might have received as a result 

of these X-ray examinations. 

3.1.2 Scope 

SRS required preemployment and annual physical examinations as part of the occupational health 

and safety program. These medical examinations, which were performed to screen for disease and 

required as a condition of employment, typically included chest X-rays. Radiation dose from these 

X-ray procedures depended on the characteristics of the X-ray machine, the number and type of 

projections for each type of procedure, and the frequency with which the examinations or procedures 

were performed. The X-ray techniques and equipment changed over the years and are presented 

and discussed in this section as they pertain to dose reconstruction. This TBD presents organ dose 

tables and supporting documentation to assist dose reconstructors in evaluating occupational doses 

as a result of these X-ray examinations. 

Attributions and annotations, indicated by bracketed callouts and used to identify the source, 

justification, or clarification of the associated information, are presented in Section 3.6. 

3.2 EXAMINATION FREQUENCIES 

SRS provided the information on the frequency of the X-ray screening examinations indicated in Table 

3-1 (Brown 2002). X-ray frequency was determined by the age of the employee and the type of work 

the employee performed. NIOSH informed DOE-HQ that it was not necessary to search for 

occupational X-rays that were performed as a condition of employment. Therefore, not all of the 

claimant records from the SRS contain all X-ray records (Brown 2002). However, the records will be 

provided by SRS upon special request if they are necessary to determine the POC. Dose 

reconstructors will assign dose in accordance with the appropriate frequencies in Table 3-1 unless the 

X-ray records were requested. In that case, all X-rays performed for screening listed in the worker file 

are to be included in the reconstruction of occupational medical dose. 

According to the information in Brown (2002), lumbar spine X-rays were not indicated as having been 

performed for screening, although they appear in some energy employees’ X-ray records, presumably 

because they were performed for first aid reasons. 

3.3 EQUIPMENT AND TECHNIQUES 

3.3.1 Photofluorography 

Photofluorography (PFG) appears to have been used at the Savannah River Plant (SRP) from about 

1951 to 1960 for mass X-ray screening of groups of people for tuberculosis. In 1953, the SRP 

contracted with Powers X-Ray Service to provide equipment and staff to X-ray 10,000 to 14,000 SRP 

employees (using PFG), including a subcontract with a Dr. Phillip Brown for the medical interpretation 

of these PFG views (DuPont, 1953). 
 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 8 of 23 

Table 3-1. Frequency of chest X-ray screening. 

Period Frequency Comment Projections 

1950–1988 Annually All employees PA chest 

Annually Construction and asbestos workers PA and LAT chest 

1989–1993 Annually Employees 50 years old and older PA chest 

Biennially Employees 40 to 49 years old PA chest 

Every 3 years Employees 39 years old and under PA chest 

Biennially Asbestos workers PA chest 

Annually DOE, USFSa

, and WSIa employees PA chest 

1994–1998 Biennially Employees 50 years old and older PA chest 

Every 3rd year Employees 40 to 49 years old PA chest 

Every 5th year Employees 39 years old and under PA chest 

Biennially Asbestos workers PA chest 

Annually DOE, USFSa

, and WSIa employees PA chest 

1999–2002 Every 5th year Employees in a health surveillance program (this likely 

means post-employment health surveillance program) 

PA chest 

Annually DOE, USFSa

, and WSIa employees PA chest 

Biennially Asbestos workers PA chest 

a. USFS = U.S. Forest Service; WSI = Wackenhut Services, Inc. 

On July 7, 1953, and February 19, 1954, the SRP issued specifications for purchase of a mobile X-ray 

unit with capability for 70-mm photofluorography (PFG) and conventional 14- × 17-in.radiographs 

(DuPont 1954). According to the bid specifications, “This mobile x-ray unit shall consist of a complete 

x-ray unit providing facilities for rapid mass chest x-rays on roll film by using photograph of a 

fluorescent screen plus facilities for conventional 14” × 17” radiography” (DuPont 1954, p. 7). Bids 

were received from Westinghouse, General Electric, and Powers X-Ray Services. Powers X-Ray 

Services, who specified Picker X-ray equipment, submitted the low bid that was accepted by the SRP 

(Savannah River Plant, 1954, pg. 70). The Picker X-ray unit was to consist of a blue light-emitting 

fluorescent screen measuring 16 × 16 inches, a 70-mm roll-film camera with a f 1.5 lens and 4 3/8 

inch focal length, and phototiming for PFG operation. When operated in the conventional radiography 

mode, either phototiming or manual timing could be selected by the operator. The unit could be 

operated with a range of 0 to 200 mA with a maximum applied kilovoltage of 140 kVp (DuPont 1954). 

Measured exposures on the Picker machine in the PFG mode have not been found. However, 

information submitted to the SRP in the Westinghouse bid (which was not accepted) but that met the 

specifications for the PFG unit that the SRP eventually purchased states that a satisfactory PFG 

image of the chest of an average male worker should be able to be obtained using 80 kVp, 20 mAs, 

and a source-to-image distance (SID) of 40 in. (DuPont 1954, p. 112). The entrance kerma in air and 

the resultant organ doses for PFG in this revision are based on the technique factors given in the 

Westinghouse bid. The entrance kerma in air in this TBD (0.5 cGy) compares favorably to that 

reported in contemporary medical literature (0.5 R) for a PFG unit with a f 1.5 camera lens, 40 in. SID, 

but slightly higher kVp and half-value layer (HVL) (Laughlin et al. 1957, p. 977). The organ doses in 

earlier revisions were based on data in ORAUT-OTIB-0006, Dose Reconstruction from Occupationally 

Related Diagnostic X-Ray Procedures (ORAUT 2005), which was intended to be used when sitespecific data was not available. 

The Works Technical Department Monthly Progress Report for November 1957 (DuPont 1957, 

p. 411) makes the following statement, reproduced in its entirety, about the mobile X-ray unit: 

Assistance was given the Project Department and the Medical Department in evaluating several 

proposed methods for reducing personnel exposures during routine chest x-rays. It was 

recommended that full size 14” × 17” chest radiographs be used in order to reduce personnel 

exposure. 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 9 of 23 

The above statement suggests that by 1957 the SRP was considering discontinuing use of the PFG 

mode on the mobile unit. Several references mention the use of the mobile unit for X-rays in 1962, 

1966, and 1991 (Cooley 1966; Rampey 1966; DuPont, 1961, 1961; and Wiley 1991), but it is 

assumed that these references pertain to the use of the mobile X-ray machine in the conventional 

radiographic mode rather than the PFG mode [1]. In the claims received to date from SRS which 

contain X-ray records, the latest documented PFG was taken in 1960 [2]. 

The documentation of PFG is not common in the claim files. There could be several reasons for this. 

It is possible that these old films were kept separately, especially if they remained on the roll and not 

cut and filed in individual film jackets, or that they have been disposed of or lost, or errors were made 

in recording individual employees’ X-rays. In the claims where X-rays were provided, PFGs are 

documented by a variety of methods. The dose reconstructor might see notations such as "roll film,’ 

"70 mm film,” "100 mm film," "35 mm film," or "7 x 8 cm film,” all of which should be interpreted as 

PFG (Birkelo et al. 1947, p. 359; Van Allen 1951, p. 832). 

Dose reconstructors should assume that workers had annual PFG examinations through 1960, unless 

the worker’s X-ray records indicate otherwise. 

3.3.2 Radiography 

A description of the X-ray equipment that was used at the SRS is included in Table 3-2. The X-ray 

equipment descriptions provided by the SRS are Type I equipment (1950 through 1970) (Cooley 

1966, 1967), Type II equipment (1971 to July 1985), Type III equipment (August 1985 to May 1999), 

and Type IV equipment (June 1999 through present 5-15-2009) (Brown 2002, Brown 2009). 

Table 3-2. Description of X-ray and ancillary equipment. 

Period Equipment 

Type I 1950–1970 Picker mobile X-ray machine (both PFG and conventional radiographic 

modes), Westinghouse machine (stationary), DuPont 2DC Safety Screens, 

DuPont Cronex 7 film, Picker X-ray tube, no grid, manual processing, manual 

collimator. 

Type II 1971–7/1985 Machine not specifieda

, DuPont Daylight Hi-Speed Screens, DuPont Cronex 7 

film, Picker X-ray tube, Stationary 12:1 grid, PAKO 3-minute film processor, 

manual collimator. 

Type III 8/1985–5/1999 Technomed,b

 DuPont Daylight Cronex 10 TL film, Quanta III screens, TecRad 

manual collimator, Technomed Recipromatic upright bucky 12:1 grid, Kodak 

M6AW 90-s X-ray film processor, Eureka X-ray tube. 

Type IV 6/1999– 

present 

Universal machine AGFA Cronex 10TK film, AGFA Curix cassettes with ortho 

regular screens, AGFA multiloader processor, TecRad manual collimator, 

Eureka Rad 68 X-ray tube, Technomed Recipromatic upright bucky 12:1 grid. 

a. The X-ray machine itself is not specified by the SRS. It is assumed for this period that the machine is the same 

Westinghouse machine in Room 719-A from the earlier period. 

b. The X-ray machine itself is not specified by the SRS. A Technomed machine is assumed for this period because a 

Technomed Upright Bucky device is mentioned by the SRS. 

3.3.3 Technique Factors 

The specific technique factors for these machines as found in SRS records are in Table 3-3. 
 

 

 

 

 

 

 

 

 

 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 10 of 23 

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

Machine Projection 

Current 

(mA) Voltage (kVp) Exposure time (s) 

Type Ia 

(Westinghouse) 

PAc

 200 56 1/10 

Type Ib (Picker 

mobile) 

PAd 50 75-95 1/10 

Type Ia 

(Westinghouse) 

LATe

 200 66 1/10 

Type IIc

 PA 300 110–120 1/30 

Type IIc

 LAT 300 120 1/15 

Type IIIc

 PA 300 120 1/40 

Type IIIc

 LAT 300 120 1/20 

Type IVc

 PA 300 120 1/40 

Type IVc

 LAT 300 120 1/20 

a. Cooley (1966). 

b. Cooley (1967). 

c. Brown (2002). 

d. The average PA chest measures 24 to 26 cm. 

e. The average LAT chest measures 34 cm. 

An internal document from November 4, 1966, mentions the calibration of medical X-ray units at the 

SRP (Cooley 1966). The document provides measurements for the stationary Westinghouse unit in 

Building 719-A only and states that the Picker mobile unit that was not currently in use should be 

calibrated in January 1967 when it would again be used (presumably in the radiographic mode). A 

followup memo by Cooley (Cooley 1967) includes not only technique factors used on the mobile 

Picker machine, but also results of TLD measurements made on the backs and chests of nine 

workers during their chest X-rays. The technique factors are listed in Table 3-3, and the organ doses 

are discussed in the organ dose section. 

Two documents mention total filtration as 2.0-mm Al in the Type I equipment (Cooley 1966; Ericson 

2003). Based on this information and the applied kilovoltage that was reportedly used during that 

period, the HVL for Type I equipment (both PFG and radiographic) is assumed to be 2.5-mm Al 

equivalent. The HVL is assumed to be higher (3.5-mm Al equivalent) for the Type II to Type IV 

equipment because of the higher voltage reportedly used, and more added filtration in more modern 

equipment. The HVLs on which dose conversion factors (DCFs) are chosen for dose reconstruction 

are listed in Table 3-4. 
 

 

3.4 

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Table 3-4. Entrance air kerma in air for various projections used at the SRS. 

Machine Projection 

Voltage 

(kVp) mAs HVL 

Air kerma rate at 

100 cm SSD (cm) 

Entrance 

kerma in 

air (cGy) 

Type I Picker PFG 80 20 2.5 0.6 mGy/mAsa

 73b 0.5c 

Type I PA 56 20 2.5 0.03 mGy/mAsa 154d 0.03 

Type I LAT 66 20 2.5 0.08 mGy/mAsa

 144e 0.04 

Type II PA 110–120 10 3.5 1.0 cGy/100 mAsf

 154d 0.044 

Type II LAT 120 20 3.5 1.0 cGy/100 mAsf

 144e 0.11 

Type III PA 120 7.5 3.5 1.0 cGy/100 mAsf

 154d 0.033 

Type III LAT 120 15 3.5 1.0 cGy/100 mAsf

 144e 0.083 

Type IV PA 120 7.5 3.5 1.0 cGy/100 mAsf

 154d 0.033 

Type IV LAT 120 15 3.5 1.0 cGy/100 mAsf

 144e 0.083 

a. ICRP 34 (1982, Figure A-1). 

b. 73 cm SSD = 102-cm SID minus 24-cm chest minus 5-cm film-to-chest distance. 

c. Rounded up from 0.3 cGy. 

d. 154 cm = 183-cm SID minus 24-cm chest minus 5-cm film-to-chest distance. 

e. 144 cm = 183-cm SID minus 34-cm chest minus 5-cm film-to-chest distance. 

f. NCRP Report 102 (1997, Table B.3). 

A standard SID of 72 in. (183 cm) was used for both posterior-anterior and lateral chest projections, 

as was standard practice (Cooley 1966; and Brown 2002). Additional information indicated that all of 

the X-ray machines were single phase and that there was no air gap between the worker and the film 

(Ericson 2003). 

ORGAN DOSE CALCULATIONS 

International Commission on Radiological Protection (ICRP) Publication 34 provides tables of average 

absorbed dose in milligray (mGy) in selected organs for selected X-ray projections at 1-Gy entrance 

air kerma in air (i.e., without backscatter) otherwise known as dose conversion factors, and for 

selected beam qualities (i.e., various HVLs) (ICRP 1982). Organ doses are found by multiplying the 

Publication 34 DCFs by the entrance air kerma in air. Entrance air kerma in air can be determined by 

actual measurement or derived from technique factors. Because few measurements exist for X-ray 

equipment at the SRS, the entrance air kerma in air values in this report were derived using the higher 

of two average air kerma rate values from Table B.3 of National Council on Radiation Protection and 

Measurements (NCRP) Report 102 (NCRP 1997) or Figure A-1 from ICRP Publication 34, the 

technique factors reported by SRS and listed in Table 3-3, and the actual source-to-skin distance 

(SSD). 

For organs without unique DCFs in ICRP Publication 34 (ICRP 1982) but specified in the Interactive 

RadioEpidemiological Program (IREP) code, DCFs for chest X-rays were generally determined by 

analogy with anatomical location (Table 3-5). Therefore, IREP code organs in the thoracic cavity but 

not mentioned in Publication 34 were assigned the same dose as the female lung, and the organs in 

the head and neck were assigned the same dose as the thyroid (with several exceptions in the case 

of poorly collimated chest radiographs and PFG as described below). 
 

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Table 3-5. ICRP Reference organs used for IREP 

organs without unique ICRP 34 dose conversion 

factors for properly collimated chest radiography. 

ICRP 34 

reference organ IREP organ 

Female Lung Thymus 

Esophagus 

Stomach 

Bone surface 

Liver, gall bladder, spleen 

Remainder organs 

Ovaries Urinary/bladder 

Colon/rectum 

Thyroid Eye/brain 

Collimation 

Collimation is an important determinant of organ dose. The DCFs in ICRP Publication 34 (ICRP 

1982) are assumed to be appropriate to use for properly collimated beams. However, it is assumed 

for the purpose of dose reconstruction that collimation practices were poor before 1970 (ORAUT 

2005). Therefore, organs that are not normally included in the primary beam of a properly collimated 

beam would have been included in the primary beam for X-ray examinations before 1970, which 

increased their dose. For example, the ovaries could have been in the primary beam of a poorly 

collimated chest X-ray beam. To account for the potential increase in dose for this situation, 

substitute DCFs are used for dose reconstruction of poorly collimated X-rays. For example, DCFs for 

the abdomen examination (instead of chest) were used to determine the dose to the ovaries, testes, 

uterus, urinary bladder, colon, and rectum. The DCF for the anterior-posterior (AP) cervical spine 

(corrected by a depth dose factor of 0.2 because the chest is performed PA) was used to determine 

the dose to the thyroid and eye/brain. Substitute DCFs used to determine dose to certain organs from 

poorly collimated beams are listed in Table 3-6. 

Table 3-6. Substitute DCFs to determine dose to certain organs from poorly collimated chest X-ray 

beams before 1970 (ORAUT 2005). 

Organ of interest Substitute DCFs 

Thyroid AP cervical spine corrected for depth by a factor of 0.2 

(NCRP 102, Table B-8, p. 103) for PA projections; LAT 

cervical spine for LAT projections. 

Eye/brain PA and LAT skull, or PA chest, whichever is larger. 

Ovaries and analogues, testes, and uterus PA and LAT abdomen. 

The X-ray beam for PFG is smaller than for conventional radiography of the chest because PFG uses 

a shorter SID of 40 in. rather than 72 in. Therefore, the poorly collimated PFG beam is assumed to 

include the thyroid, thoracic organs, liver, gall bladder, spleen, but not the eye/brain, gonads, urinary 

bladder, or the colon/rectum (ORAUT 2005). 

The DCFs and organ doses are listed in Tables 3-8 through 3-10. The doses are in units of rem and 

assume a quality factor of 1 for X-rays. Skin doses were determined in accordance with the method 

in ORAUT (2005) and are listed in Tables 3-11 and 3-12 for PA and LAT chest X-rays, respectively. 

The calculated entrance and exit skin doses were compared to the measured entrance and exit skin 

doses of Cooley (Cooley, 1967) made on the mobile Picker machine for the PA chest for the 1950­

1970 time period. The comparison is shown in Table 3-7. 
 

 

 

 

 

 

 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 13 of 23 

Table 3-7. Comparison of calculated and measured entrance and exit skin doses for Type I X-ray 

equipment. 

Dose parameter Calculated Valuea Measured Valueb 

Entrance Skin Dose, PA 

Chest 

41 mrem 17-36 mrem 

Exit Skin Dose 0.9 mrem 0.5-1 mrem 

a. Entrance air kerma in air multiplied by the HVL dependent backscatter factor (ORAUT 2005). 

b. Cooley (1967). 

Table 3-8. Organ doses from PFGa

 at SRS, 1951 to 1960. 

Organ 

DCF (mGy per Gy air kerma) 

(beam quality 2.5 mm aluminum HVL)b Organ dose (rem)c 

Thyroid 174d 8.70E-02 

Eye/brain 32 1.60E-02 

Ovaries 1 5.00E-04 

Urinary bladder 1 5.00E-04 

Colon/rectum 1 5.00E-04 

Testes 0.01 5.00E-06 

Lungs (male) 419 2.10E-01 

Lungs (female) 451 2.26E-01 

Thymus 451 2.26E-01 

Esophagus 451 2.26E-01 

Stomach 451 2.26E-01 

Bone surface 451 2.26E-01 

Liver/gall bladder/spleen 451 2.26E-01 

Remainder organs 451 2.26E-01 

Breast 49 2.45E-02 

Uterus (embryo) 1.3 6.50E-04 

Bone marrow (male) 92 4.60E-02 

Bone marrow (female) 86 4.30E-02 

a. All doses based on SID of 102 cm. 

b. DCFs from Tables A.2 through A.8, ICRP Publication 34 (1982). 

c. These organ doses should be doubled if records indicate a stereo PFG. 

d. DCF for AP cervical spine, corrected for depth by 0.2. 
 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 14 of 23 

Table 3-9. ICRP Publication 34 DCFs for PA and LAT radiographic chest projections for 2.5- and 3.5­

mm Al HVL.a 

Organ Projection 

DCF (mGy per Gy air kerma) 

2.5 mm Al HVL 

Poor collimation 

DCF (mGy per Gy air kerma) 

3.5 mm Al HVL 

Proper collimation 

Thyroid PA 174b 62 

LAT 137b

 151 

Eye/brain PA 32b 62 

LAT 137b

 151 

Ovaries PA 168b 3.2 

LAT 57b 1.6 

Testes PA 9.1b 0.01 

LAT 3.3b 0.1 

Lungs (male) PA 419 565 

LAT 193 276 

Lungs (female) PA 451 610 

LAT 220 310 

Breast PA 49 91 

LAT 255 316 

Uterus/(embryo) PA 149b 3 

LAT 43b 1.4 

Bone marrow (male) PA 92 146 

LAT 37 61 

Bone marrow (female) PA 86 141 

LAT 29 48 

a. DCFs from Tables A.2 through A.8, ICRP Publication 34 (1982). 

b. Substitute DCFs from Table 3-6. 
 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 15 of 23 

Table 3-10. Organ doses from PA and LAT chest X-rays at SRS. 

Organ Projection 

Organ dose 

(rem) 

1950–1970 

Type I 

Organ dose 

(rem) 

1971–7/1985 

Type II 

Organ dose 

(rem) 

8/1985–5/1999 

Type III 

Organ dose 

(rem) 

6/1999-present 

Type IV 

Thyroid PA 5.22E-03 2.73E-03 2.05E-03 2.05E-03 

LAT 5.48E-03 1.66E-02 1.25E-02 1.25E-02 

Eye/brain PA 9.60E-04 2.73E-03 2.05E-03 2.05E-03 

LAT 5.48E-03 1.66E-02 1.25E-02 1.25E-02 

Ovaries PA 5.04E-03 1.41E-04 1.06E-04 1.06E-04 

LAT 2.28E-03 1.76E-04 1.32E-04 1.32E-04 

Urinary/bladder PA 5.04E-03 1.41E-04 1.06E-04 1.06E-04 

LAT 2.28E-03 1.76E-04 1.32E-04 1.32E-04 

Colon/rectum PA 5.04E-03 1.41E-04 1.06E-04 1.06E-04 

LAT 2.28E-03 1.76E-04 1.32E-04 1.32E-04 

Testes PA 2.73E-04 4.40E-07 3.30E-07 3.30E-07 

LAT 1.32E-04 1.10E-05 8.25E-06 8.25E-06 

Lungs (male) PA 1.26E-02 2.49E-02 1.86E-02 1.86E-02 

LAT 7.72E-03 3.04E-02 2.29E-02 2.29E-02 

Lungs (female) PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Thymus PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Esophagus PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Stomach PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Bone surface PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Liver/gall 

bladder /spleen 

PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Remainder 

Organs 

PA 1.35E-02 2.68E-02 2.01E-02 2.01E-02 

LAT 8.80E-03 3.41E-02 2.56E-02 2.56E-02 

Breast PA 1.47E-03 4.00E-03 3.00E-03 3.00E-03 

LAT 1.02E-02 3.48E-02 2.61E-02 2.61E-02 

Uterus/(embryo) PA 4.47E-03 1.32E-04 9.90E-05 9.90E-05 

LAT 1.72E-03 1.54E-04 1.16E-04 1.16E-04 

Bone marrow 

(male) 

PA 2.76E-03 6.42E-03 4.82E-03 4.82E-03 

LAT 1.48E-03 6.71E-03 5.03E-03 5.03E-03 

Bone marrow 

(female) 

PA 2.58E-03 6.20E-03 4.65E-03 4.65E-03 

LAT 1.16E-03 5.28E-03 3.98E-03 3.98E-03 

Table 3-11. Skin dose guidance for various chest projections and time periods. 

Area of skin PFG <1970 

PA Chest 

<1970 

LAT Chest 

>1970 

PA Chest 

>1970 

LAT Chest 

R Front 

Shoulder 

EXSDb EXSDb ENSDa EXSDb ENSDa 

R Back 

Shoulder 

ENSD ENSD ENSD ENSD ENSD 

L Front 

Shoulder 

EXSD EXSD EXSD EXSD EXSD 

L Back 

Shoulder 

ENSD ENSD EXSD ENSD EXSD 
 

 

 

 

 

 

 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 16 of 23 

R Upper Arm 

to Elbow 

10% 

ENSDc 

ENSD ENSD 10% ENSD ENSD 

L Upper Arm 

to Elbow 

10% ENSD ENSD EXSD 10% ENSD EXSD 

L Hand ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 

R Hand ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 

L Elbow, 

Forearm, Wrist 

R Elbow, 

Forearm, Wrist 

10% ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 

R Elbow, 

Forearm, Wrist 

R Elbow, 

Forearm, Wrist 

10% ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 

R Side of 

Head 

(including ear) 

10% ENSD 10% ENSD Eye/Brain 10% ENSD 10% ENSD 

L Side of Head 

(including ear) 

10% ENSD 10% ENSD Eye/Brain 10% ENSD 10% ENSD 

Front Left 

Thigh 

RSD 

(0.52m) e 

RSD (0.52m) RSD (0.52m) RSD (0.52m) RSD (0.52m) 

Back Left 

Thigh 

RSD 

(0.52m) 

RSD (0.52m) RSD (0.52m) RSD (0.52m) RSD (0.52m) 

Front Right 

Thigh 

RSD 

(0.52m) 

RSD (0.52m) RSD (0.52m) RSD (0.52m) RSD (0.52m) 

Back Right 

Thigh 

RSD 

(0.52m) 

RSD (0.52m) RSD (0.52m) RSD (0.52m) RSD (0.52m) 

L Knee and 

below 

RSD 

(0.86m) f 

RSD (0.86m) RSD (0.86m) RSD (0.86m) RSD (0.86m) 

R Knee and 

below 

RSD 

(0.86m) 

RSD (0.86m) RSD (0.86m) RSD (0.86m) RSD (0.86m) 

L Side of Face Eye/Brain Eye/Brain Eye/Brain Eye/Brain 10% ENSD 

R Side of Face Eye/Brain Eye/Brain Eye/Brain Eye/Brain 10% ENSD 

L Side of Neck 10% ENSD ENSD Eye/Brain 10% ENSD 10% ENSD 

R Side of 

Neck 

10% ENSD ENSD Eye/Brain 10% ENSD 10% ENSD 

Back of Head 10% ENSD 10% ENSD Eye/Brain 10% ENSD 10% ENSD 

Front of Neck Eye/Brain Eye/Brain Eye/Brain Thyroid 10% ENSD 

Back of Neck 10% ENSD ENSD Eye/Brain 10% ENSD 10% ENSD 

Front Torso: 

Base of neck 

EXSD EXSD Lung EXSD Lung 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 17 of 23 

to end of 

sternum 

Front Torso: 

End of 

sternum to 

lowest rib 

EXSD EXSD Lung EXSD Lung 

Front Torso: 

Lowest Rib to 

iliac crest 

EXSD EXSD Lung 10% EXSD 10% Lung 

Front Torso: 

Iliac crest to 

pubis 

10% 

EXSDd 

10% EXSD 10% Lung 10% EXSD 10% Lung 

Back Torso: 

Base of neck 

to mid-back 

ENSD ENSD Lung ENSD Lung 

Back Torso: 

Mid-back to 

lowest rib 

ENSD ENSD Lung ENSD Lung 

Back Torso: 

Lowest rib to 

iliac crest 

ENSD ENSD Lung 10% ENSD 10% Lung 

Back Torso: 

buttocks (Iliac 

crest and 

below) 

10% ENSD 10% ENSD 10% Lung 10% ENSD 10% Lung 

Right Torso: 

Base of neck 

to end of 

sternum 

ENSD ENSD ENSD ENSD ENSD 

Right Torso: 

End of 

sternum to 

lowest rib 

ENSD ENSD ENSD ENSD ENSD 

Right Torso: 

Lowest Rib to 

iliac crest 

ENSD ENSD ENSD 10% ENSD 10% ENSD 

Right Torso: 

Iliac crest to 

pubis (R hip) 

10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD 

Left Torso: 

Base of neck 

to end of 

sternum 

ENSD ENSD EXSD ENSD EXSD 

Left Torso: 

End of 

sternum to 

lowest rib 

ENSD ENSD EXSD ENSD EXSD 

Left Torso: 

Lowest Rib to 

iliac crest 

ENSD ENSD EXSD 10% ENSD 10% EXSD 

Left Torso: 

Iliac crest to 

pubis (L hip) 

10% ENSD 10% ENSD 10% EXSD 10% ENSD 10% EXSD 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 18 of 23 

a Entrance skin dose (ENSD) is entrance air kerma in air, multiplied by a backscatter factor of 1.35 and 1.4 for 2.5 mm Al 

HVL and 3.5 mm Al HVL respectively, from NCRP Report No. 102 (1997), Table B-8. 

b Exit skin dose (EXSD) is the entrance skin dose divided by the absorption factor for a 24 or 34 cm chest and appropriate 

HVL, divided by 0.9 to account for uncertainty in tabulated absorption factors in Table B-7 of NCRP Report 102 (NCRP, 

1997). 

c. 10% ENSD also called the "Outside but near primary beam" dose (ORAUT 2005). 

d. 10% EXSD also called the "Outside but near exit beam" dose (ORAUT 2005). 

e. Calculated based on 0.52 m from center of chest (ORAUT 2005). 

f. Calculated based on 0.86 m from center of chest (ORAUT 2005). 

Table 3-12. Dose in rem to various areas of skin from PA and LAT chest X-rays 

Area of skin PFG 1951-

1960 

PA Chest 

1950-

1970 

LAT 

Chest Up 

1950-

1970 

PA Chest 

1971-

1985 

LAT Chest 

1971-1985 

PA Chest 

1985-

present 

LAT Chest 

1985-

present 

R Front Shoulder 1.47E-02 9.E-04 5.40E-02 1.8E-03 1.54E-01 1.4E-03 1.16E-01 

R Back Shoulder 6.75E-01 4.05E-02 5.40E-02 6.16E-02 1.54E-01 4.62E-02 1.16E-01 

L Front Shoulder 1.47E-02 9.E-04 2.E-04 1.8E-03 9.E-04 1.4E-03 7.E-04 

L Back Shoulder 6.75E-01 4.05E-02 2.E-04 6.16E-02 9.E-04 4.62E-02 7.E-04 

R Upper Arm to Elbow 6.75E-02 4.05E-02 5.40E-02 6.2E-03 1.54E-01 4.6E-03 1.16E-01 

L Upper Arm to Elbow 6.75E-02 4.05E-02 2.E-04 6.2E-03 9.E-04 4.6E-03 7.E-04 

L Hand 6.75E-01 4.05E-02 5.4E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

R Hand 6.75E-01 4.05E-02 5.4E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

L Elbow, Forearm, 

Wrist 

R Elbow, Forearm, 

Wrist 

6.75E-02 4.05E-02 5.4E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

R Elbow, Forearm, 

Wrist 

R Elbow, Forearm, 

Wrist 

6.75E-02 4.05E-02 5.4E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

R Side of Head 

(including ear) 

6.75E-02 4.1E-03 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

L Side of Head 

(including ear) 

6.75E-02 4.1E-03 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Front Left Thigh 2.E-04 1.E-05 8.E-06 2.E-05 3.E-05 2.E-05 2.E-05 

Back Left Thigh 2.E-04 1.E-05 8.E-06 2.E-05 3.E-05 2.E-05 2.E-05 

Front Right Thigh 2.E-04 1.E-05 8.E-06 2.E-05 3.E-05 2.E-05 2.E-05 

Back Right Thigh 2.E-04 1.E-05 8.E-06 2.E-05 3.E-05 2.E-05 2.E-05 

L Knee and below 7.E-05 4.E-06 3.E-06 8.E-06 1.E-05 6.E-06 8.E-06 

R Knee and below 7.E-05 4.E-06 3.E-06 8.E-06 1.E-05 6.E-06 8.E-06 

L Side of Face 1.60E-02 1.E-03 5.5E-03 2.7E-03 1.54E-02 2.0E-03 1.16E-02 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 19 of 23 

R Side of Face 1.60E-02 1.E-03 5.5E-03 2.7E-03 1.54E-02 2.0E-03 1.16E-02 

L Side of Neck 6.75E-02 4.05E-02 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

R Side of Neck 6.75E-02 4.05E-02 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Back of Head 6.75E-02 4.1E-03 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Front of Neck 1.60E-02 1.E-03 5.5E-03 2.7E-03 1.54E-02 2.0E-03 1.16E-02 

Back of Neck 6.75E-02 4.05E-02 5.5E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Front Torso: Base of 

neck to end of sternum 

1.47E-02 9.E-04 8.8E-03 1.8E-03 3.41E-02 1.4E-03 2.57E-02 

Front Torso: End of 

sternum to lowest rib 

1.47E-02 9.E-04 8.8E-03 1.8E-03 3.41E-02 1.4E-03 2.57E-02 

Front Torso: Lowest 

Rib to iliac crest 

1.47E-02 9.E-04 8.8E-03 2.E-04 3.4E-03 1.E-04 2.6E-03 

Front Torso: Iliac 

crest to pubis 

1.5E-03 9.E-05 9.E-04 2.E-04 3.4E-03 1.E-04 2.6E-03 

Back Torso: Base of 

neck to mid-back 

6.75E-01 4.05E-02 8.8E-03 6.16E-02 3.41E-02 4.62E-02 2.57E-02 

Back Torso: Mid-back 

to lowest rib 

6.75E-01 4.05E-02 8.8E-03 6.16E-02 3.41E-02 4.62E-02 2.57E-02 

Back Torso: Lowest 

rib to iliac crest 

6.75E-01 4.05E-02 8.8E-03 6.2E-03 3.4E-03 4.6E-03 2.6E-03 

Back Torso: buttocks 

(Iliac crest and below) 

6.75E-02 4.1E-03 9.E-04 6.2E-03 3.4E-03 4.6E-03 2.6E-03 

Right Torso: Base of 

neck to end of sternum 

6.75E-01 4.05E-02 5.40E-02 6.16E-02 1.54E-01 4.62E-02 1.16E-01 

Right Torso: End of 

sternum to lowest rib 

6.75E-01 4.05E-02 5.40E-02 6.16E-02 1.54E-01 4.62E-02 1.16E-01 

Right Torso: Lowest 

Rib to iliac crest 

6.75E-01 4.05E-02 5.40E-02 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Right Torso: Iliac 

crest to pubis (R hip) 

6.75E-02 4.1E-03 5.4E-03 6.2E-03 1.54E-02 4.6E-03 1.16E-02 

Left Torso: Base of 

neck to end of sternum 

6.75E-01 4.05E-02 2.E-04 6.16E-02 9.E-04 4.62E-02 7.E-04 

Left Torso: End of 

sternum to lowest rib 

6.75E-01 4.05E-02 2.E-04 6.16E-02 9.E-04 4.62E-02 7.E-04 

Left Torso: Lowest 

Rib to iliac crest 

6.75E-01 4.05E-02 2.E-04 6.2E-03 9.E-05 4.6E-03 7.E-05 

Left Torso: Iliac crest 

to pubis (L hip) 

6.75E-02 4.1E-03 2.E-05 6.2E-03 9.E-05 4.6E-03 7.E-05 

UNCERTAINTY 

ORAUT-OTIB-0006 (ORAUT 2005) lists the major sources of uncertainty in X-ray output intensity and 

subsequent dose to the worker. The five sources of uncertainty are 1) X-ray beam measurement 

error (±2%); 2) variation in applied voltage (±9%); 3) variation in X-ray beam current (±5%); 4) 

variation in exposure time (±25%); 5) variation in SSD as a result of worker size (±10%). The 10% 

uncertainty in output intensity as a result of worker size was based on an inverse square correction of 

output intensity changes resulting from differences of standard chest thickness of ±7.5 cm. 

Information on worker thickness is rarely available, even in the medical literature. However, at SRS 

entrance skin dose measurements were made on nine workers of varying chest thicknesses (builds) 

3.5 
3.6 

Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 20 of 23 

(Cooley, 1967). While Cooley (1967) does not report the measured chest thicknesses for these nine 

workers, the entrance skin doses are reported and reflect the increases in exposure needed to 

radiograph thicker body parts, in this case, chests. Cooley (1967) reports the mean of the measured 

entrance skin doses as 27 mrem. The standard uncertainty of the range of measurements is 5.6, 

resulting in an uncertainty of 21% from this source. 

Substituting this value into the root mean square calculation for combined uncertainty described in 

OTIB 0006 (ORAUT 2005) instead of the 10% value used in that document, the resultant standard 

uncertainty is 34% from these five sources. Rounding this up to 35% would seem to provide an 

adequate and suitably conservative indication of uncertainty. For further conservatism, it may be 

appropriate to assume that errors are all positive and that only +35% should be used as suggested in 

ORAUT-OTIB-0006 (ORAUT 2005). 

ATTRIBUTIONS AND ANNOTATIONS 

Where appropriate in this document, bracketed callouts have been inserted to indicate information, 

conclusions, and recommendations provided to assist in the process of worker dose reconstruction. 

These callouts are listed here in the Attributions and Annotations section, with information to identify 

the source and justification for each associated item. Conventional References, which are provided in 

the next section of this document, link data, quotations, and other information to documents available 

for review on the Project’s Site Research Database. 

[1] Thomas, Elyse M. Oak Ridge Associated Universities. Health Physicist. March 2009. 

Given that the mobile Picker machine had both PFG and conventional radiographic (14 x 17 

film) capability, and that by 1957 SRP was aware of the higher doses delivered with the use of 

PFG, it is reasonable to assume that references to use of the mobile Picker machine after 

about 1957 are to its use in the conventional radiographic mode, and not the PFG mode. 

[2] Thomas, Elyse M. Oak Ridge Associated Universities. Health Physicist. March 2009. 

Approximately 150 SRS cases with X-ray records were reviewed and analyzed. Thirteen of 

these cases had recorded PFG, all within the dates of 1952-1960. 
Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 21 of 23 

REFERENCES 

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Association, volume 133, number 6, pp. 359–366. [SRDB Ref ID: 22392] 

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Institute for Occupational Safety and Health, Office of Compensation Analysis and Support), 

ESH-WHS-2002-00017, Westinghouse Savannah River Company, Savannah River Site, 

Aiken, South Carolina, November 12. [SRDB Ref ID: 8819] 

Brown, K. T., 2009, Documented communication, Brown, K to Hoff, J, Response to question about 

 SRS X- Ray Equipment, May 14. [SRDB Ref ID: 66950] 

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Cooley, R.C., 1967, “Personnel Radiation Exposures from Medical X-rays – Savannah River Plant – 

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DuPont (E. I. du Pont de Nemours and Company), Savannah River Plant, 1954. Specifications, Bids, 

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Savannah River Plant, Aiken, South Carolina. [SRDB Ref ID: 4049] 

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Areas D-C-K-L-P-R-H-F,” Savannah River Plant Medical Department Bulletin, December 11. 

[SRDB Ref ID: 4054] 

Ericson, Marilyn, 2003, ”Historical X-Ray Equipment and Methods at the Savannah River Site” 

documented communication, Oak Ridge Associated Universities Team, Oak Ridge, 

Tennessee, February 10. [SRDB Ref ID: 29844] 

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

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

Laughlin, J. S., M. L. Muerk, I. Pullman, and R. S. Sherman, 1957, “Bone, Skin, and Gonadal Doses 

in Routine Diagnostic Procedures," American Journal of Roentgenology, Radium Therapy and 

Nuclear Medicine, volume 78, number 6, pp. 961–982. [SRDB Ref ID: 13071] 

NCRP (National Council on Radiation Protection and Measurements), 1997, Medical X-Ray, Electron 

Beam and Gamma-Ray Protection for Energies up to 50 MeV (Equipment Design, 

Performance and Use), Report 102, 3rd Reprinting (February 28, 1997), Bethesda, Maryland. 

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Tennessee, December 21. 

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Document No. ORAUT-TKBS-0003-3 Revision No. 04 Effective Date: 11/30/2009 Page 23 of 23 

Glossary 

air kerma 

Air kerma in air is the sum of kinetic energy of all charged particles liberated per unit mass. 

The unit is the joule per kilogram (J kg-1) and is given the special name gray (Gy). 

gray (Gy) 

The International System of Units unit of absorbed dose (1 Gy = 1 joule per kilogram). 

ionizing radiation 

Electromagnetic or particulate radiation capable of producing charged particles through 

interactions with matter. 

rad 

The traditional unit of absorbed dose (one rad = 100 ergs per gram of material absorbing the 

radiation energy). 

rem 

The rem is the traditional unit of dose equivalent, which is equal to the product of the absorbed 

dose in rad and the quality factor of the radiation (1 rem = 0.1 Gy). 

skin dose 

Absorbed dose at a tissue depth of 7 mg/cm2

 ~ 0.07 mm in tissue. 

X-ray 

(1) Ionizing electromagnetic radiation of external nuclear origin, or (2) a radiograph.