ORAU TEAM

Dose Reconstruction

Project for NIOSH

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

Page 1 of 14

Document Title:

Argonne National Laboratories - East - 

Occupational Medical Dose

Document Number: ORAUT-TKBS-0036-3 

Revision: 01 PC-1 

Effective Date: 03/27/2006

Type of Document: TBD 

Supersedes: Revision 00

Subject Expert: Theresa Lopez

Document Owner

Approval: Signature on File Approval Date: 01/05/2006

Norman D. Rohrig, TBD Team Leader

Approval: Signature on File Approval Date: 01/05/2006

Judson L. Kenoyer, Task 3 Manager

Concurrence: Signature on File Concurrence Date: 01/05/2006

Kate Kimpan, Project Director

Approval: Signature on File Approval Date: 01/09/2006

Stuart L. Hinnefeld, Health Science Administrator

 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-0036-3 Revision No. 01 PC-1 Effective Date: 03/27/2006 Page 2 of 14

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION 

NUMBER DESCRIPTION

11/18/2005 00 New technical basis document for Argonne National LaboratoriesEast - Occupational Medical Dose. First approved issue. Initiated by 

Norman D. Rohrig.

01/09/2006 01 Approved revision initially converted from a page change to a 

revision. Incorporates additional information based on informal 

discussions with NIOSH. Incorporates information from review of 

claimant files. Clarifies that coverage begins July 1946. Moves 

tables closer to references in the text. Text was added and/or 

modified in Sections 3.1, 3.3, 3.5.2, and 3.6 (pages 5, 7, 9, 10, 11, 

and 13). Initiated by Norman D. Rohrig.

03/27/2006 01 PC-1 Approved page change revision. Page change initiated to revise

analog/surrogate Table 3-4 on page 9 in Section 3.5.1 to remove 

uterus as a surrogate organ for ovaries. No sections were deleted. 

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

Norman D. Rohrig. Approval:

Document Owner:

Signature on File ________________________ Norman D. Rohrig, TBD Team Leader 03/20/2006

Signature on File___________________________ Judson L. Kenoyer, Task 3 Manager 03/17/2006

Signature on File ________ Edward F. Maher, Task 5 Manager 03/17/2006

Signature on File_________________ Kate Kimpan, Projector Director 03/22/2006

Signature on File____________________ Stuart L. Hinnefeld, Health Science Administrator 03/27/2006
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 3 of 14

TABLE OF CONTENTS

SECTION TITLE

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

PAGE

4

3.1 Introduction ....................................................................................................................................5

3.2 Background....................................................................................................................................6

3.3 Examination Frequency .................................................................................................................6

3.4 Equipment and Techniques ...........................................................................................................7

3.5 Organ Dose Estimates...................................................................................................................8

 3.5.1 Parameters and Estimation Method .................................................................................. 8

 3.5.2 Organ Dose Estimates for ANL-E Workers ....................................................................... 9

3.6 Uncertainties................................................................................................................................10

References ...........................................................................................................................................14

LIST OF TABLES

TABLE TITLE PAGE

3-1 X-ray equipment and examination frequency at ANL-E by year.................................................7

3-2 Entrance kerma by procedure and period...................................................................................8

3-3 Modified ICRP DCFs; absorbed dose for organs at various Al HVL for PFG 

and radiography ..........................................................................................................................9

3-4 Analogs for IREP organs not specified in ICRP (1982) ..............................................................9

3-5 Organ dose estimates for chest PFG, as presented in ORAU (2005) ......................................10

3-6 Organ doses from lumbar spine X-ray, 1940-1960...................................................................11

3-7 Organ dose estimates for chest X-rays.....................................................................................11
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 4 of 14

ACRONYMS AND ABBREVIATIONS

ANL E Argonne National Laboratories East

AP anterior-posterior

C.F.R. Code of Federal Regulations

cm centimeter

DOE U.S. Department of Energy

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 2000

ESE entrance skin exposure

Gy gray

HVL half-value layer

ICRP International Commission on Radiological Protection

IREP Interactive RadioEpidemiological Program

kerma initial kinetic energy of charged particles liberated by indirectly ionizing radiation per 

unit mass 

keV kilo-electron volt

kVp kilovolt peak

LAT lateral

LS lumbar spine

mm millimeter

NCRP National Council on Radiation Protection and Measurements

NIOSH National Institute for Occupational Safety and Health

PA posterior-anterior

PFG photofluorography/photofluorographic

SID source-to-image distance

SSD source-to-skin distance

TBD technical basis document

U.S.C. United States Code

yr year
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 5 of 14

3.1 INTRODUCTION 

Technical basis documents (TBDs) and Site Profile documents are general working documents that 

provide guidance concerning 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 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 EEOICPA [42 U.S.C. § 

7384I(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 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 [probability of causation] guidelines established under 

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

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

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

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

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

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

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

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

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

exclusion. Therefore, the statute requires NIOSH to include all radiation exposures in its dose 

reconstructions for employees at DOE facilities, including radiation exposures related to the Naval 

Nuclear Propulsion Program. As a result, all internal and external dosimetry results are considered 

valid for use in dose reconstruction. No efforts are made to determine the eligibility of any fraction of 

total measured exposure for inclusion in dose reconstruction.

Argonne National Laboratory was established on July 1, 1946 and this TBD is intended to cover since 

that date. The work was a continuation of that done by the Metallurgical Laboratory of the University 

of Chicago beginning in 1941 which is an Atomic Weapons Employer under EEOICPA. The job 

locations did not change until land and buildings were acquired for the laboratory. 

As part of the requirements for employment at Argonne National Laboratories-East (ANL-E) from the 

1940s to the present, all employees might have received X-rays as part of periodic physical 

examinations in addition to preemployment and termination X-rays. These could include annual 

radiographic examinations of the chest, photofluorographic (PFG) chest examinations or, after 1980,
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 6 of 14

periodic chest X-ray examinations for workers who used respirators or smoked (Stalker 2005; Lopez

2005a). Before 1960, lumbar spine (LS) X-ray examinations were routinely performed (Stalker 2005). 

NIOSH, in its role to reconstruct occupational dose under EEOICPA, has classified diagnostic medical 

x-rays administered in conjunction with routine or special physical examinations required for 

employment as occupational exposures (NIOSH 2002). This TBD discusses medical exposures 

required as a condition of employment; it does not include diagnostic and therapeutic procedures not 

required for employment. 

The following sections describe the methodology used to estimate absorbed dose from X-ray 

exposure for ANL-E workers. In the absence of available data, assumptions are claimant-favorable. 

This section provides introductory text. Section 3.2 provides background information for this TBD 

analysis. Section 3.3 describes X-ray examination frequency at ANL-E. Section 3.4 provides 

information on equipment and techniques used at ANL-E, including assumptions necessitated by lack 

of protocol, measurement, or records data. Section 3.5 provides organ dose estimates by calendar 

year and type of X-ray. Section 3.6 documents uncertainties.

3.2 BACKGROUND

As described in Protection of the Patient in Diagnostic Radiology (ICRP 1982), the amount of energy 

absorbed in the body and its distribution in specific organs can be determined by measurement or 

calculation. Absorbed dose in tissue, measured in units of gray (Gy), is equal to the energy absorbed 

per unit mass at a point in the human body. 

The radiation dose received in a given examination varies widely throughout the body. Doses are 

highly dependent on the technical factors employed, characteristics of the equipment, collimation of 

the beam, and number of films taken. The general equation for total annual occupational medical 

dose provided by NIOSH (2002) guidelines is:

Dom = ΣnDi (3–1)

where

Dom = occupational medical dose

n = Number of examinations in a calendar year

Di = dose from the X-ray procedure

The NIOSH guidelines state that medical records should contain the dates, types, and number of 

X-ray examinations, and that if there is no known information about the energy spectra, values should 

be assumed conservatively to be in the 30- to 250-kV photon range (a claimant-favorable assumption)

(NIOSH 2002). The guidance states the assumption that the uncertainty distribution about each X-ray 

procedure follows a normal distribution, with Dom being the mean dose.

X-ray inspection data are available from 1988 to the present. For those years, measured entrance 

skin exposure (ESE) was used to estimate organ doses. For years prior to 1988, default estimates 

have been used until site-specific data can be identified.

3.3 EXAMINATION FREQUENCY 

The frequency and type of X-ray examinations for ANL-E workers from 1940 to the present have been 

determined through interviews with ANL-E medical personnel (Stalker 2005; Lopez 2005a; Lopez 

2005b). Written or historical protocol noting the frequency of chest X-ray examinations as a function 
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 7 of 14

of job category has not been located. However, it is believed that chest X-ray examinations were 

performed at hire, annually, and at termination from the 1940s through 1980, and that both posterioranterior (PA) and lateral (LAT) views were taken. Through 1958, stereo PA views were taken. It is 

possible that chest PFG was performed until 1956; it is known to have been performed in the 1940s 

and would likely have ended in 1949 when the medical department moved from the University of 

Chicago. However, persons receiving their annual x-ray examination at the University of Chicago 

may have received PFG examinations until 1956 as evidenced in a review of claimant files. In 

addition, anterior-posterior (AP) and LAT LS X-rays were performed at the time of hire from 1946 

through 1960 (Stalker 2005; Lopez 2005a; Lopez 2005b; four views assumed). From 1980 to the 

present, PA chest X-rays have been taken at hire, every 4 yr while employed if the worker wore a 

respirator or smoked, and at termination. Table 3-1 summarizes examination frequency and all 

known machine types for ANL-E. Only one exception to the frequency denoted below was found in a 

review of claimant files: one worker received chest x-rays approximately every 3 months for 1 year 

due to working with tuberculosis infected monkeys. The reason for the x-rays was noted in the 

claimant’s medical files; it did not appear in the claimant’s description of work. More frequent chest xrays were also noted in worker files for pneumonia and neoplasm diagnosis, but these are outside the 

scope of the TBD. 

Table 3-1. X-ray equipment and examination frequency at ANL-E by year.

a

Date Procedure Frequency Machine type Source of dose estimate

1946-1956 PFG Chest 

X-ray:

Chest stereo PA and single 

LAT 

LS AP and LAT (4 views)

Chest: Hire, annual, 

and termination 

LS: Hire only 

Unknown; performed at 

University of Chicago 

Default values from ORAU (2005) 

1957-1959 X-ray:

Chest stereo PA and single 

LAT 

LS AP and LAT (4 views) 

Chest: Hire, annual, 

and termination 

LS: Hire only 

GE (unknown model) Default values from ORAU (2005)

1960-1969 X-ray

Chest PA and LAT 

Hire, annual, and 

termination 

GE (unknown model) Default values from ORAU (2005) 

1970-1980 X-ray

Chest PA and LAT

Hire, annual, and 

termination

GE DXD-350

Single-phase

Default values from ORAU (2005)

1981-1987 X-ray

Chest PA

Hire, every 4 yr for 

some workers

GE DXD-350

Single-phase

Default values from ORAU (2005)

1988-present X-ray

Chest PA

Hire, every 4 yr for 

some workers

GE Advantix

Three-phase

Measured ESE

(Stalker 2005; X-ray Survey 2005)

a. Stalker (2005). 

3.4 EQUIPMENT AND TECHNIQUES

The analysis assumed that ANL-E radiological practices followed standards of medical practice to 

minimize dose to the patient; however, the type of equipment, technique factors, and machine 

calibrations used before 1988 are not known. 

This TBD uses default dose estimates from Technical Information Bulletin: Dose Reconstruction from 

Occupationally Related Diagnostic X-ray Procedures (ORAU 2005) to provide organ dose estimates 

from occupational X-ray examinations administered at ANL-E from 1946 through 1969 (pre-1970), 

1970 to 1985, and 1986 to 1987. For the years before 1970, the default values assume minimal 

beam collimation and a half-value layer (HVL) of 2.5 mm Al. For 1970 to 1985, the default values

assume beam collimation and an HVL of 2.5 mm Al. For years after 1985 through 1987, the default 

values assume collimation and an HVL of 4.0 mm Al. For 1988 and later, doses have been calculated 

from measured ESE for PA chest X-rays (Stalker 2005; X-ray Survey 2005).
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 8 of 14

Table 3-1 lists the assumed type and frequency of exposure by period. Records of machine settings

prior to 1988 are not available, so this TBD uses default estimates for LAT and PA chest X-rays and 

LS X-rays from ORAU (2005). 

Efforts will continue to locate related additional site-specific information. Until the location of more 

accurate records, these assumptions provide the only available estimates.

3.5 ORGAN DOSE ESTIMATES

This section discusses organ dose estimates. Section 3.5.1 describes the methodology used to 

estimate these doses, and Section 3.5.2 discusses results.

3.5.1

This analysis used measured ESE data for 1988 and later. It used ESE data for PA chest X-ray (and 

for one period, LAT chest X-ray); when necessary, the estimated LAT chest X-ray ESE was 2.5 times 

the PA chest ESE (ORAU 2005). Table 3-2 lists measured and estimated ESE. ESE (units of gray) 

was multiplied by the appropriate dose conversion factor to estimate organ doses.

Parameters and Estimation Method

Table 3-2. Entrance kerma by procedure and period. 

Period

Entrance kerma, 

cGy, PA chest

Entrance kerma, 

cGy, LAT chest

ESE, rem, AP 

lumbar spine

ESE, rem, LAT 

lumbar spine

ESE, chest 

PFG, cGy

1946-1948 N/Aa N/A 4 10 3.0

Pre-1970b 0.2 0.5 4 10 N/A

1970-1985b 0.1 0.25 N/A N/A N/A

1985-1987b 0.05 0.13 N/A N/A N/A

1988-1989c 0.0105 0.026 N/A N/A N/A

1990-1991c 0.009 0.0225 N/A N/A N/A

1992-1993c 0.006 0.015 N/A N/A N/A

1994-1995c 0.0135 0.0338 N/A N/A N/A

1996-1997c 0.0133 0.0333 N/A N/A N/A

1998-1999c 0.0068 0.017 N/A N/A N/A

2000-2001c 0.0069 0.0173 N/A N/A N/A

2002-2004c 0.0069 0.0173 N/A N/A N/A

2005d 0.0078 0.0138 N/A N/A N/A

a. N/A – Not Applicable 

b. ORAU (2005).

c. Measured ESE for PA Chest. LAT entrance kerma is 2.5 × PA Chest ESE. 

d. Measured LAT ESE available for this year only (X-ray Survey 2005).

For the years before 1988, organ dose estimates are based on the values in ORAU (2005). Table 3-2 

lists default entrance kerma for PA and LAT chest X-rays from ORAU (2005). Table 3-3 lists dose 

conversion factors (DCFs). 

The International Commission on Radiological Protection (ICRP) tables used to estimate absorbed 

dose (ICRP 1982) do not include all the organs in the Interactive RadioEpidemiological Program 

(IREP). For organs in IREP that are not identified in the ICRP tables, use the dose conversion 

coefficient that is anatomically closest to the IREP-specified organs to estimate dose. For example, 

the factor for lung can be applied to all other organs in the thoracic cavity, such as the esophagus and 

bone surface. For abdominal organs (bladder, colon), use the dose coefficient for ovaries. This 

approach should be either claimant-favorable or neutral. Table 3-4 lists analogs for IREP organs, as 

originally presented in ORAU (2005).
Document No. ORAUT-TKBS-0036-3 Revision No. 01 PC-1 Effective Date: 03/27/2006 Page 9 of 14

Table 3-3. Modified ICRP DCFs (mGy per Gy air kerma); absorbed dose (1 mGy) for organs at 

various Al HVL for PFG and radiography (ORAU 2005; ICRP 1982).a

Organ

Dose conversion factors–LS

Dose 

conversion 

factors

PFG chest PA

(Pre-1970)

Dose conversion factors–chest

Pre-1970 

(2.0-mmAl HVL)

Pre-1970 

(2.0-mmAl HVL)

Pre-1970 

(2.5-mm Al HVL)

1970-1985

(2.5-mm Al HVL)

Post-1985

(4.0-mm Al HVL)

LAT AP LAT PA LAT PA LAT PA

Thyroid 0.1 0.2 174b 137 174b 115 32 164 78

Eye/brain 0.1 0.2 32 137 32 115 32 164 78

Ovaries N/Ac N/Ac N/A N/A N/A 0.6 1 2.5 5.2

Liver/gall bladder/spleen 10d 62d 451 220 451 220 451 351 674

Urinary bladder N/Ad N/Ad N/A N/A N/A 0.6 1 2.5 5.2

Colon/rectum N/Ad N/Ad N/A N/A N/A 0.6 1 2.5 5.2

Testes N/Ac N/Ac N/A N/A N/A 0.1 0.01 0.1 0.01

Lungs (male) 10 62 419 193 419 193 419 313 628

Lungs (female) 10 62 451 220 451 220 451 351 674 

Thymusd 10 62 451 220 451 220 451 351 674

Esophagusd 10 62 451 220 451 220 451 351 674

Stomachd 10 62 451 220 451 220 451 351 674 

Bone surfacesd 10 62 451 220 451 220 451 351 674

Remainderd 10 62 451 220 451 220 451 351 674

Female breast 9.5e 18e 49 255 49 255 49 343 116

Uterus 20 217 N/A N/A N/A 0.6 1.3 2.1 5.2

Bone marrow (male) 15 24 92 37 92 37 92 76 178

Bone marrow (female) 15 24 86 29 86 29 86 59 172

Skinc 1.32f 1.32f 1.35f 1.35f 1.35f 1.35f 1.35f 1.40f 1.40f

a. Table 3-4 lists organ doses for all organs.

b. Per ORAU (2005), DCF for AP c-spine corrected for depth by 0.2

c. Organ dose values for the testes and ovaries for lumbar spine reflect actual measurements reported in Lincoln and Gupton (1958).

d. Using analogs listed in Table 3-4.

e. DCFs for lumbar spine examination not given in ICRP (1982). Values for the respective upper gastrointestinal examinations were used instead.

f. Calculated using backscatter factor from NCRP 102 (1989, Table B-3) (ORAU 2005); see Table 3-5. 

Table 3-4. Analogs for IREP organs not specified in ICRP (1982). 

Anatomical 

location

ICRP 34 

reference organ IREP organ analogsa

Thoracic cavity Lung Thymus, esophagus, stomach, bone surface, liver/gall bladder, remainder organs

Abdominal cavity Ovaries Urinary bladder, colon/rectum

Head and neck Thyroid Eye/brain

a. ORAU (2005).

3.5.2

Table 3-5 lists default organ doses from PA PFG examinations (ORAU 2005) for 1941 through 1956 

and Table 3-6 lists default organ doses (assumes 4 views) from LAT and AP lumbar spine X-rays that 

dose reconstructors should use for 1946 through 1959. If medical records show only 2 views, the 

dose reconstructor should divide the values by 2 (Lopez 2005b). Additionally, if it is known that 

medical x-ray examinations were conducted at ANL-E facilities rather than at the University of 

Chicago, then it is unlikely that PFG was performed after 1949. However, a review of claimant files 

showed that PFG was possible up through 1956 if the claimant received annual physical examinations 

at the University of Chicago. 

Organ Dose Estimates for ANL-E Workers

Table 3-7 lists default and calculated organ dose estimates from LAT and PA chest X-ray 

examinations for each period (before 1970, 1970 to 1985, and 1986-1987, and two year periods from 

1988 through 2005). The estimates for exposure from chest X-rays for the pre-1988 periods are from 

default values in Table 5 of ORAU (2005) while site-specific information is being obtained. Note that 

stereo PA examinations were routinely performed through 1958.
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 10 of 14

Table 3-5. Organ dose estimates for chest PFG 

(rem), 1946 - 1956, as presented in ORAU 

(2005). 

Organ PA (rem)

Thyroid 5.22E-01

Eye/brain 9.60E-02

Ovaries 2.5E-02a

Liver/gall bladder/spleen 1.35E+00

Urinary bladder 2.5E-02a

Colon/rectum 2.5E-02a

Testes 5.0E-03a

Lungs (male) 1.26E+00

Lungs (female) 1.35E+00

Thymus 1.35E+00

Esophagus 1.35E+00

Stomach 1.35E+00

Bone surfaces 1.35E+00

Remainder 1.35E+00

Female breast 1.47E-01

Uterus 2.5E-02a

Bone marrow (male) 2.76E-01

Bone marrow (female) 2.58E-01

Skinb 4.05E+00

a. Modified from Webster and Merrill (1957), as presented 

in ORAU (2005).

b. Calculated in ORAU (2005) using backscatter factor of 

1.35 from NCRP 102 (1989, Table B-3). 

3.6 UNCERTAINTIES

As defined in ORAU (2003, 2005), error is deviation from the correct, true, or conventionally accepted 

value of a quantity, and uncertainty is in terms of the potential range of a stated, measured, or 

assumed or otherwise determined value of a quantity. Error and uncertainty provide an indication of 

confidence in the dose estimates. Uncertainty, expressed in terms of a confidence level, is a more 

appropriate term than error, which implies that the actual value is known. Uncertainty, stated as a 

probability of falling within a stated range, includes precision and reproducibility of the measurement 

as well as accuracy (that is, how close the estimate comes to the actual value).

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

contribute the most uncertainty to the dose estimate: measurement error, variation in applied 

kilovoltage, variation in beam current, variation in exposure time, and source-to-skin distance (SSD). 

Film speed, the use of screens, or the use of grids would not affect the beam output intensity. The 

lack of historical records for these measurements for most years at ANL-E introduces a large 

uncertainty into the dose estimates that cannot be readily quantified, although there is no apparent 

reason to believe that practices at ANL-E or its medical subcontractors were different from those at 

other facilities or from recommended standards of the medical community at the time. Therefore, the 

use of default estimates and reliance on information from other DOE sites when site-specific 

information was unavailable is likely to approximate X-ray performance at ANL-E closely. The 

following estimates of uncertainty associated with X-ray exposure are from ORAU (2005), on which 

this TBD analysis relied for default information in the absence of site-specific records. The analysis 

also used X-ray inspection records for 1988 and later; such records indicate that X-ray equipment at 

ANL-E was performing within an acceptable range and without any problems. The uncertainty 

estimates below will probably overestimate uncertainty for those years.
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 11 of 14

Table 3-6. Organ doses from lumbar spine X-ray, 1946-

1959 (ORAU 2005). 

Organ

Estimated dosea,b,c

HVL = 2.0 mm Al (collimated);

Entrance kerma = 0.20 cGy

LAT (rem) AP (rem)

Thyroid 1.00E-04 8.00E-04

Eye/brain 1.00E-04 8.00E-04

Ovaries 1.52E+00d 1.12E+00d

Liver/gall bladder/spleen 1.00E-01 2.48E-01

Urinary bladder 1.52E+00d 1.12E+00d

Colon/rectum 1.52E+00d 1.12E+00d

Testes 1.12E+01d 5.40E-02d

Lungs 1.00E-01 2.48E-01

Thymus 1.00E-01 2.48E-01

Esophagus 1.00E-01 2.48E-01

Stomach 1.00E-01 2.48E-01

Bone surfaces 1.00E-01 2.48E-01

Remainder 1.00E-01 2.48E-01

Female breast 9.50E-02 7.20E-02

Uterus 2.00E-01 8.68E+00

Bone marrow 1.50E-01 9.60E-02

Skine 1.32E+01 5.28E+00

a. Source-to-image distance (SID) = 99 cm. 

b. Image receptor size 35.6 cm by 43.2 cm. 

c. Value is doubled to account for two exposures.

d. Organ dose values the testes and ovaries (and analogs) for lumbar 

spine reflect actual measurements reported in Lincoln and Gupton 

(1958). 

e. Skin dose values include backscatter factors of 1.32 from 

Table B.8 of NCRP 102 (1989).

Table 3-7. Organ dose estimates for chest X-rays (rem). 

Organ

Pre-1970 

Estimated dosea,b,c

HVL = 2.5 mm Al 

(uncollimated)

1970-1985 

Estimated dosea,b,c

HVL = 2.5 mm Al 

(collimated)

1986-1987 

Estimated dose a,b

HVL = 4.0 mm Al 

(collimated)

1988-1989 

Estimated dose a,b

HVL = 4.0 mm Al 

(collimated)

1990-1991 

Estimated dose a,b

HVL = 4.0 mm Al 

(collimated)

LAT PA LAT PA LAT PA LAT PA LAT PA

Thyroid 6.85E-02 3.48E-02 2.88E-02 3.20E-03 2.13E-02 3.90E-03 4.31E-03 8.19E-04 3.69E-03 7.02E-04

Eye/brain 6.85E-02 6.4E-03 2.88E-02 3.20E-03 2.13E-02 3.90E-03 4.31E-03 8.19E-04 3.69E-03 7.02E-04

Ovaries 1.3E-02c 2.5E-02c 1.50E-04 1.00E-04 3.25E-04 2.60E-04 6.56E-05 5.46E-05 5.63E-05 4.68E-05

Liver/gall bladder/ 

spleen

1.10E-01 9.02E-02 5.5E-02 4.5E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03 

Urinary bladder 1.3E-02c 2.5E-02c 1.50E-04 1.00E-04 3.25E-04 2.60E-04 6.56E-05 5.46E-05 5.63E-05 4.68E-05

Colon/rectum 1.3E-02c 2.5E-02c 1.50E-04 1.00E-04 3.25E-04 2.60E-04 6.56E-05 5.46E-05 5.63E-05 4.68E-05

Testes 2.5E-03c 5.00E-03c 2.5E-05 1.00E-06 1.30E-05 5.00E-07 2.63E-06 1.05E-07 2.25E-06 9.00E-08

Lungs 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03

Thymus 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03

Esophagus 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03

Stomach 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03 

Bone surfaces 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03

Remainder 1.1E-01 9.02E-02 5.50E-02 4.51E-02 4.56E-02 3.37E-02 9.21E-03 7.08E-03 7.90E-03 6.07E-03

Female breast 1.28E-01 9.8E-03 6.38E-02 4.90E-03 4.46E-02 5.80E-03 9.00E-03 1.22E-03 7.72E-03 1.04E-03

Uterus 1.3E-02c 2.5E-02c 1.50E-04c 1.30E-04c 2.73E-04 2.60E-04 5.51E-05 5.46E-05 4.73E-05 4.68E-05

Bone marrow 1.85E-02 1.84E-02 9.25E-03 9.20E-03 9.88E-03 8.90E-03 2.00E-03 1.87E-03 1.71E-03 1.60E-03

Skind,e 6.75E-01 2.7E-01 3.38E-01 1.35E-01 1.82E-01 7.00E-02 3.73E-02 1.49E-02 3.20E-02 1.28E-02
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 12 of 14

Table 3-7 (continued). Organ dose estimates for chest X-rays (rem). 

Organ

1992-1993

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

1994-1995

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

1996-1997 

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

1998-1999

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

2000-2004

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

LAT PA LAT PA LAT PA LAT PA LAT PA

Thyroid 2.46E-03 4.68E-04 5.54E-03 1.05E-03 5.45E-03 1.04E-03 2.79E-03 5.30E-04 2.83E-03 5.38E-04

Eye/brain 2.46E-03 4.68E-04 5.54E-03 1.05E-03 5.45E-03 1.04E-03 2.79E-03 5.30E-04 2.83E-03 5.38E-04 

Ovaries 3.75E-05 3.12E-05 8.44E-05 7.02E-05 8.31E-05 6.92E-05 4.25E-05 3.54E-05 4.31E-05 3.59E-05

Liver/gall bladder/

spleen

5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Urinary bladder 3.75E-05 3.12E-05 8.44E-05 7.02E-05 8.31E-05 6.92E-05 4.25E-05 3.54E-05 4.31E-05 3.59E-05

Colon/rectum 3.75E-05 3.12E-05 8.44E-05 7.02E-05 8.31E-05 6.92E-05 4.25E-05 3.54E-05 4.31E-05 3.59E-05 

Testes 1.50E-06 6.00E-08 3.38E-06 1.35E-07 3.33E-06 1.33E-07 1.70E-06 6.80E-08 1.73E-06 6.90E-08

Lungs 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Thymus 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03 

Esophagus 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Stomach 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Bone surfaces 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Remainder 5.27E-03 4.04E-03 1.18E-02 9.10E-03 1.17E-02 8.96E-03 5.97E-03 4.58E-03 6.05E-03 4.65E-03

Female breast 5.15E-03 6.96E-04 1.16E-02 1.57E-03 1.14E-02 1.54E-03 5.83E-03 7.89E-04 5.92E-03 8.00E-04

Uterus 3.15E-05 3.12E-05 7.09E-05 7.02E-05 6.98E-05 6.92E-05 3.57E-05 3.54E-05 3.62E-05 3.59E-05

Bone marrow 1.14E-03 1.07E-03 2.57E-03 2.40E-03 2.53E-03 2.37E-03 1.29E-03 1.21E-03 1.31E-03 1.23E-03 

Skine 2.13E-02 8.52E-03 4.79E-02 1.92E-02 4.72E-02 1.89E-02 2.41E-02 9.66E-03 2.45E-02 9.80E-03

Organ

2005

Estimated dosea,b

HVL = 4.0 mm Al 

(collimated)

LAT PA

Thyroid 2.23E-03 6.08E-04

Eye/brain 2.23E-03 6.08E-04 

Ovaries 3.40E-05 4.06E-05

Liver/gall 

bladder/spleen

4.77E-03 5.26E-03

Urinary bladder 3.40E-05 4.06E-05

Colon/rectum 3.40E-05 4.06E-05 

Testes 1.36E-06 7.80E-08

Lungs 4.77E-03 5.26E-03

Thymus 4.77E-03 5.26E-03

Esophagus 4.77E-03 5.26E-03

Stomach 4.77E-03 5.26E-03

Bone surfaces 4.77E-03 5.26E-03

Remainder 4.77E-03 5.26E-03 

Female breast 4.66E-03 9.05E-04

Uterus 2.86E-05 4.06E-05

Bone marrow 1.03E-03 1.39E-03 

Skine 1.44E-03 1.11E-02

a. SID = 183 cm.

b. Image receptor size 35.6 cm by 43.2 cm.

c. Modified from Webster and Merrill (1957) as presented in ORAU (2005).

d. Calculated in ORAU (2005) using backscatter factor of 1.35 from NCRP 102 (1989, Table B-3) for skin dose estimates 

through 1985.

e. Calculated in ORAU (2005) using backscatter factor of 1.40 from NCRP 102 (1989, Table B-3) for skin dose estimates 

after 1985.

ORAU (2005) reports that X-ray doses are derived largely from actual measurements of X-ray 

machine output with R-meters or similar ionization chamber devices. These typically had an 

uncertainty of +2% for photon energies below 400 keV, if properly calibrated and used. Although 

more current machinery could have a smaller uncertainty, +2% is assumed to be conservative.

Variation in applied voltage generally falls within +5% of the machine setting. Beam intensity is 

approximately proportional to the 1.7 power of the kilovoltage, resulting in an uncertainty of 

approximately +9% in relation to beam intensity for voltages in the 110- to 120-kVp range. Variations 

in tube current are normal and generally small. As the tube current drops, beam intensity falls in 
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 13 of 14

direct proportion. Large decreases in beam output would be readily detectable and would indicate the 

need for machine maintenance or, as a temporary measure, an increase in the current or voltage to 

provide the necessary intensity for proper radiography. ORAU (2005) estimates the variation in tube 

current to be approximately +5% for this parameter. 

Exposure time can significantly affect the dose received from radiography (exposure times are a 

fraction of second). Even a small variation in exposure time due to timer error can significantly 

change beam output. Because early X-ray machine timers are known to have been inaccurate, 

ORAU (2003, 2005) assume uncertainty in beam output due to timers to be +25%. 

SSD can contribute to variability because the ESE is determined by this distance. Variations result 

from accuracy of positioning as well as patient size (thickness). As expressed in ORAU (2003, 2005), 

this is generally thought to vary by no more than a few centimeters, with an upper limit of 7.5 cm 

(+10%).

A potentially large source of uncertainty for ANL-E is the number and type of X-rays taken. As noted 

above, interviews of current medical personnel indicated that the current protocol is one PA chest 

X-ray at hire, then as needed, but not more frequently than every 4 years. Prior to 1980, different 

protocols were in effect. No official historical protocol has been found, but it is reported that PFG was 

used prior to the medical department opening at its current location and that lumber spine X-rays were 

taken in years prior to at least 1960. This analysis assumed that the protocol for chest X-rays would 

have been consistent with those at other sites, and a review of claimant files showed that annual xrays were most common prior to 1980. Therefore, at this time, dose reconstructors should assume an 

annual chest X-ray for all workers in all years prior to 1980 (stereo PA through 1958), lumbar spine Xrays at hire for all workers prior to 1960, and performance of PFG up through 1956, which is the latest 

reference found. The analysis assumed four views in the dose estimates presented here (AP, APspot, LAT, and LAT-spot), consistent with default dose estimates from ORAU (2005) until the location 

of more specific information.

Consistent with ORAU (2003, 2005), the TBD analysis calculated the statistical root mean square to 

estimate total uncertainty. The root mean square is the square root of the sum of the squares of the 

individual uncertainty values, and equals 28.9%. An estimate of 30% uncertainty at one sigma for a 

normal distribution should be entered into IREP.
Document No. ORAUT-TKBS-0036-3 Revision No. 01 Effective Date: 01/09/2006 Page 14 of 14

REFERENCES 

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

Diagnostic Radiology, Publication 34, Pergamon Press, New York, New York.

Lincoln, T. A., and E. D. Gupton, 1958, “Radiation Doses in Diagnostic X-ray Procedures,” Radiology, 

Volume 71, pp. 208-215.

Lopez, T. K. 2005a, “Answers to additional questions regarding ANL-E x-ray protocol,” memorandum

to file, MFG Inc., Fort Collins, Colorado, May 27.

Lopez, T. K. 2005b, “Conversation with Dr. Francis Strehl regarding ANL-E x-ray protocol”, 

memorandum to file, MFG Inc., Fort Collins, Colorado, September 27.

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

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

Performance, and Use), Report 102, Bethesda, Maryland.

NIOSH (National Institute for Occupational Safety and Health), 2002, External Dose Reconstruction 

Implementation Guidelines, Revision 1, OCAS-IG-001, Office of Compensation Analysis and 

Support, Cincinnati, Ohio. 

ORAU (Oak Ridge Associated Universities), 2003, Technical Basis Document for the Savannah River 

Site, ORAUT-TKBS-0003, Oak Ridge, Tennessee.

ORAU (Oak Ridge Associated Universities), 2005, Technical Information Bulletin: Dose 

Reconstruction from Occupationally Related Diagnostic X-ray Procedures, ORAUT-OTIB0006, Rev. 03, Oak Ridge, Tennessee. April 19. 

Stalker, J, 2005, NIOSH Site Survey notes to William Luck, April 13.

Webster, E. W., and O. E. Merrill, 1957, “Measurements of Gonadal Dose in Radiographic 

Examinations,” New England Journal of Medicine, 257:811-819.

X-ray Survey 1988-2000, 2005, Document Capture of X-ray inspection records for ANL-E (pp. 10-16, 

17-56), April 22.