ORAU TEAM

Dose Reconstruction

Project for NIOSH

Oak Ridge Associated Universities I Dade Moeller I MJW Technical Services

Page 1 of 21

DOE Review Release 08/31/2012

Document Title:

Paducah Gaseous Diffusion Plant –

Occupational Medical Dose

Document Number: ORAUT-TKBS-0019-3

Revision: 03

Effective Date: 08/23/2012

Type of Document: TBD

Supersedes: Revision 02

Subject Expert(s): Jodie L. Phillips and Elyse M. Thomas

Approval: Signature on File Approval Date: 08/20/2012

Jodie L. Phillips, Document Owner

Concurrence: Signature on File Concurrence Date: 08/21/2012

John M. Byrne, Objective 1 Manager

Concurrence: Signature on File Concurrence Date: 08/20/2012

Edward F. Maher, Objective 3 Manager

Concurrence: Vickie S. Short Signature on File for Concurrence Date: 08/21/2012

Kate Kimpan, Project Director

Approval: Signature on File Approval Date: 08/23/2012

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-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 2 of 21

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION

NUMBER DESCRIPTION

02/05/2004 00 New technical basis document for the Paducah Gaseous Diffusion 

Plant – Occupational Medical Dose. First approved issue. Initiated 

by Jay J. Maisler.

09/26/2006 01 Revised as a result of biennial review. Approved Revision 01. 

Constitutes a total rewrite of the document. Incorporates internal 

formal review comments. Incorporates NIOSH formal review 

comments. This revision results in a reduction in assigned dose and 

no PER is required. Training required: As determined by the Task 

Manager. Initiated by Daniel S. Mantooth.

06/18/2007 02 Approved revision initiated to add Attribution and Annotations 

Section. Constitutes a total rewrite of the document. Incorporates 

formal internal and NIOSH review comments. This revision results in 

no change to the assigned dose and no PER is required. Training 

required: As determined by the Task Manager. Initiated by Daniel S. 

Mantooth. 

08/23/2012 03 Revision initiated to add assignment of dose from lumbar spine Xrays. Incorporated all site specific information found into dose 

assessments. Added skin doses from all procedures and periods. 

Added ORAUT-OTIB-0079 Rev 00 reference. Incorporates formal 

internal and NIOSH review comments. Constitutes a total rewrite of 

the document. Training required: As determined by the Objective 

Manager. Initiated by Jodie L. Phillips.
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 3 of 21

TABLE OF CONTENTS

SECTION TITLE PAGE

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

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

3.1.1 Purpose........................................................................................................................ 6

3.1.2 Scope........................................................................................................................... 6

3.2 Examination Frequencies......................................................................................................... 6

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

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

3.3.2 Chest Radiography – 1951–1974 ................................................................................. 7

3.3.3 Chest Radiography – 1975–1995 ................................................................................. 7

3.3.4 Chest Radiography – 1996–Present............................................................................. 8

3.3.5 Lumbar Spine Radiography – 1951–1974 .................................................................... 8

3.3.6 Lumbar Spine Radiography – 1975–1979 .................................................................... 8

3.4 Organ Dose Calculations ......................................................................................................... 9

3.5 Uncertainty............................................................................................................................... 9

3.6 Attributions and Annotations .................................................................................................. 18

References ........................................................................................................................................ 19

Glossary ............................................................................................................................................ 20

LIST OF TABLES

TABLE TITLE PAGE

3-1 Frequency of chest X-ray examinations ...................................................................................7

3-2 Technical parameters pertinent to dose reconstruction ............................................................ 9

3-3 Organ dose equivalents for chest projections for all periods................................................... 10

3-4 Organ dose equivalents for lumbar spine projections for all periods....................................... 11

3-5 Skin dose guidance and skin dose equivalents for chest projections, 

1951 – 1974...........................................................................................................................12

3-6 Skin dose guidance and skin dose equivalents for chest projections, 

1975 – 1995...........................................................................................................................13

3-7 Skin dose guidance and skin dose equivalents for chest projections, 

1996 – present.......................................................................................................................14

3-8 Skin dose guidance and skin dose equivalents for lumbar spine 

projections, 1951 – 1979........................................................................................................ 15
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ACRONYMS AND ABBREVIATIONS

AP anterior-posterior

cGy centigray

cm centimeter

DCF dose conversion factor

DOE U.S. Department of Energy

EEOICPA Energy Employees Occupational Illness Compensation Program Act

ENSD entrance skin dose

EXSD exit skin dose

GE General Electric Corporation

Gy gray

HVL half-value layer

ICRP International Commission on Radiological Protection

in. inch

IREP Interactive RadioEpidemiological Program

kVp peak kilovoltage

LAT lateral (X-ray projection)

mAs milliampere second

mm millimeter

mR milliroentgen

NCRP National Council on Radiation Protection and Measurements

NIOSH National Institute for Occupational Safety and Health

OBL oblique

PA posterior-anterior 

PGDP Paducah Gaseous Diffusion Plant

POC probability of causation

RAO right anterior oblique

RSD remote skin dose

s second

SRDB Site Research Database

SSD source-to-skin distance

TBD technical basis document

U.S.C. United States Code

yr year

§ section or sections
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 5 of 21

3.1 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) restrict the “performance of duty” 

referred to in 42 U S. C. § 7384n(b) to nuclear weapons work (NIOSH 2010).

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 2010):

• 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-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 6 of 21

3.1.1 Purpose

The purpose of this technical basis document is to describe the occupational medical X-ray screening 

program and practices at the Paducah Gaseous Diffusion Plant (PGDP). This document discusses 

historical and current practices in relation to the evaluation of dose from medical X-ray procedures for 

PGDP workers. Dose reconstructors will use this information as needed to assign medical X-ray 

doses to workers’ EEOICPA claims at PGDP.

3.1.2 Scope

The NIOSH Dose Reconstruction Project requires assessment of doses from medical X-rays that 

were performed for screening and required as a condition of employment. This TBD contains tables 

of organ dose equivalents (including skin) that result from chest and lumbar spine procedures 

performed for screening at PGDP. The tables are the result of an assessment of the incident air 

kerma at the source-to-skin distance (SSD), based on specific operating parameters for the facility 

insofar as these are known.

3.2 EXAMINATION FREQUENCIES

The PGDP occupational medicine program required preemployment, periodic, and termination

screening chest X-ray examinations (Union Carbide 1958, p. 50; Ely et al. 1957, p.11). The chest 

examinations usually consisted of one posterior-anterior (PA) in the early years, and both a PA and a 

lateral (LAT) starting in the mid-1970s and continuing into the 1980s and 1990s (Turner 2003). While 

there are some LAT chest projections in the claim file records before the mid-1970s, they were much 

more commonly performed after that time. Dose reconstructors should include the dose from LAT 

chest projections if they appear in the claim file records. If the records state “PA chest”, only dose 

from the PA chest should be assigned. If the records state “Chest”, the dose reconstructor should 

assign dose from the PA only from 1951 through 1973, and dose from both the PA and LAT chest 

from 1974 to the present.

A few oblique (OBL) chest X-rays appear in the claim file records for asbestos workers. Because the 

OBL chest projection can be useful in the diagnosis of asbestosis (ORAUT 2011a), an occupational 

disease, dose from this projection should be included if it appears in the claim file records.

About half the claim file records include lumbar spine X-rays that can be reasonably assumed to have 

been performed for screening; in other words, they do not appear to have been performed for jobrelated injuries. However, no historical information has been found about lumbar spine X-rays at 

Paducah. Because they appear quite frequently in the claim file records, it will be assumed that 

lumbar spine examinations were performed for screening on some workers. It will also be assumed 

that the lumbar spine examination consisted of two projections, AP and LAT. Dose reconstructors 

should include dose from lumbar spine X-rays only if they appear in the claim file records, and only 

through 1979.

Table 3-1 lists default chest examination frequencies for PGDP employees for dose reconstructors to 

use in the absence of claim file records. 
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 7 of 21

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

Period Employees Frequency Projections

1951–1973 All Every 2 yra PA only

1974–presentb Nonsmokers Every 5 yrc PA and LAT

Smokers under age 40 Every 5 yrc PA and LAT

Smokers age 40 and older Every 3 yrc PA and LAT

1986–present Asbestos workers Every 2 yrc PA and LAT

1974–present All workers if smoking history or 

asbestos exposure is unknown.

Every 2 yra PA and LAT

a. Based on average interval between chest X-rays in claim file records.

b. Ex-smokers are considered smokers for 10 years after quitting.

c. From Turner (2003).

3.3 EQUIPMENT AND TECHNIQUES

3.3.1 Photofluorography

A review of a sample of claim file records does not indicate PFG was prevalent, although a 

“photoroentgen” chest X-ray (PFG) taken in 1954 was found during the review. No historical 

information has been located to indicate use of PFG at Paducah. Ely et al. (1957, p. 11) specifically 

mentions the taking of “chest X-rays on 14 in. × 17 in. film,” and that “this is the best practice for 

reducing exposure.” Dose reconstructors should include dose from PFG procedures if they are 

indicated in the claim file records, using the organ doses from ORAUT-OTIB-0006 (ORAUT 2011a). 

Because PFG does not appear to be prevalent at PGDP, it should not be assumed in the absence of 

records.

3.3.2 Chest Radiography – 1951–1974

A General Electric (GE) machine was used from the start of PGDP operations in 1951 through 1974 

(Turner 2003). However, no historical information has been found about this machine, or the 

technique factors that might have been used during this period. Therefore, the organ doses for this 

period come from ORAUT-OTIB-0006 (ORAUT 2011a), and are reproduced in the organ dose tables 

for convenience.

3.3.3 Chest Radiography – 1975–1995

In 1975, the GE machine was replaced by a Picker unit (Collins 1988), which was used through 1995.

The same X-ray technician has operated the X-ray unit at PGDP from November 1974 to 2003. He 

was interviewed in 2003, and provided technique factors for chest X-rays for males and females of 

various builds such as small, medium, and large (Turner 2003). The technique factors for the 

medium-sized male of 95 kVp, 16 mAs (for the PA chest) and 95 kVp and 64 mAs (for the LAT chest) 

were used in the determination of the incident air kerma for this period in this TBD.

Food and Drug Administration personnel surveyed the Picker machine in 1988, and measured the 

half-value layer (HVL), which was 3.0 mm Al at 80 kVp (Collins 1988). According to NCRP Report 

102, the HVL would be approximately 3.2 mm Al at the 95 kVp used for chest X-rays, which implies a 

total filtration in the machine of 3.5 mm Al eq. (NCRP 1997, Table B-2). An HVL of 3.5 mm Al is 

assumed for the dose calculations in this TBD.

The tabulated values of average air kerma rates in NCRP Report 102 assume a total filtration of 

2.5 mm Al eq. (NCRP 1997, Table B-3). From the HVL measurement, it appears the Picker machine 

probably had 3.5 mm Al eq. total filtration; the average air kerma rate of 0.2 cGy/100 mAs at 95 kVp 

was corrected to reflect an additional millimeter of aluminum total filtration using the equation in

ORAUT-OTIB-0006 (ORAUT 2011a, p. 9). The incident air kerma rate used to calculate organ doses 
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 8 of 21

for the PA chest, after correcting for additional filtration, the actual mAs used for chest X-rays at 

Paducah, and the SSD, is 2.99 × 10-2 cGy. The incident air kerma rate for the LAT chest of 1.39 × 10-

1 cGy was calculated in the same way, but using the 64 mAs reportedly used for the LAT chest, and 

using the SSD for the LAT chest. 

3.3.4 Chest Radiography – 1996–Present

The present PGDP X-ray equipment has been in operation since January 1996 and consists of a 

single-phase XMA machine (Turner 2003). Gregory (2003) surveyed this equipment and measured 

an HVL of 3.85 mm of Al at 100 kVp. Gregory reported the technique factors for PA chest of 90 kVp 

and 15 mAs, with a measured exposure of 19 mR at 183 cm. 

The tabulated values of average air kerma rates in NCRP Report 102 assume a total filtration of 

2.5 mm Al eq. (NCRP 1997, Table B-3). From the HVL measurement, it appears the XMA machine 

probably has 3.5 mm Al eq. total filtration; the average air kerma rate of 0.18 cGy/100 mAs at 90 kVp 

was corrected to reflect an additional millimeter of aluminum total filtration using the equation in

ORAUT-OTIB-0006 (ORAUT 2011a, p. 9). The incident air kerma rate used to calculate organ doses 

for the PA chest, after correcting for additional filtration, the actual mAs used for the PA chest, and the 

SSD, is 2.52 × 10-2 cGy. A calculation of the incident air kerma using the 19-mR measured exposure 

at 183 cm and converting from exposure in air to air kerma and SSD yields a comparable but slightly 

lower result.

The incident air kerma for the LAT chest of 6.31 × 10-2 cGy was calculated by multiplying the incident 

air kerma for the PA chest by 2.5 (ORAUT 2011a), because Gregory (2003) did not report technique 

factors for the LAT chest projection.

3.3.5 Lumbar Spine Radiography – 1951–1974

While no historical evidence exists that lumbar spine X-rays were performed for screening at PGDP, 

about half the claim file records in the 1950s, 1960s, and 1970s contain lumbar spine X-rays. They 

appear frequently enough to consider them as a screening examination for some workers. 

There is no evidence of technique factors or machine measurements for the 1952–1974 period, so 

organ doses from the lumbar spine examinations come from ORAUT-OTIB-0006 (ORAUT 2011a). 

The lumbar spine examination is assumed to consist of an anterior-posterior (AP) and LAT lumbar 

spine projection. Poor collimation will be assumed through 1974 to coincide with the change of 

equipment at PGDP in 1975, even though ORAUT-OTIB-0006 assumes good collimation starting in 

1970.

Dose reconstructors should assign dose from lumbar spine examinations only if they appear in the 

claim file records. Lumbar spine examinations should not be assumed to have been performed for 

screening if the records are not available, because they clearly were not performed on all workers.

3.3.6 Lumbar Spine Radiography – 1975–1979

There is no evidence of technique factors or machine measurements for the 1975–1979 period, so 

organ doses from the lumbar spine examination come from ORAUT-OTIB-0006 (ORAUT 2011a). 

The lumbar spine examination is assumed to consist of an AP and LAT lumbar spine projection. 

While there are some lumbar spine measurements and technique factors reported in Collins (1988) 

and Gregory (2003), these are later than the period of frequent lumbar spine examinations in the 

claim file records. Dose reconstructors should assign dose from lumbar spine examinations only if 
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 9 of 21

they appear in the claim file records, and only through 1979. In 1980 and later, the lumbar spine 

examinations that appear in the records were probably not performed for screening.

Table 3-2 summarizes the technical parameters pertinent to dose reconstruction for Paducah. 

Table 3-2. Technical parameters pertinent to dose reconstruction.

Period Projection kVp HVL(mm Al)

Incident air 

kerma (cGy)

1951 – 1974 PA chest -- 2.5a 0.20a

LAT chestb -- 2.5a 0.50a

AP lumbar spine -- 2.0a 1.44a

LAT lumbar spine -- 2.0a 3.79a

1975 – 1995 PA chest 95c 3.5d 2.99E-02e

LAT chest 95c 3.5d 1.39E-01e

AP lumbar spine -- 2.5a 0.91a

LAT lumbar spine -- 2.5a 3.48a

1996–present PA chest 90f 3.5f 2.52E-02e

LAT chest 90f 3.5f 6.31E-02e

a. From ORAUT-OTIB-0006 (ORAU 2011a).

b. Assign dose only if recorded in claim file records for this period.

c. From Turner (2003).

d. From Collins (1988).

e. Calculated as described in the text.

f. From Gregory (2003).

Regular repeat/retake analyses for the X-ray department have been performed for a number of years. 

The actual repeat rate is not known. There is no indication that the repeat rate has been of any 

significance (Turner 2003).

3.4 ORGAN DOSE CALCULATIONS

Organ doses for PFG, PA and LAT chest X-rays, and AP and LAT lumbar spine X-rays were 

determined based on the method described in ORAUT-OTIB-0006 (ORAUT 2011a) and dose 

conversion factors in International Commission on Radiological Protection (ICRP) Publication 34 

(ICRP 1982), which provides tables of average absorbed dose (in milligrays) in selected organs for 

selected X-ray projections at 1-Gy entrance kerma (i.e., air kerma without backscatter) for selected 

projections and selected beam qualities (i.e., various HVLs). These tables list the basic dose 

conversion factors (DCFs) for converting air kerma to organ dose. Substitute DCFs for organs that 

are listed in the Interactive RadioEpidemiology Program (IREP) but without unique DCFs in ICRP 

Publication 34 (ICRP 1982) were selected as described in ORAUT-OTIB-0006 or are footnoted in the 

organ dose tables. Air kerma was obtained from Table 3-2.

Table 3-3 lists the organ doses from chest X-rays for all periods. Table 3-4 lists the organ doses from 

lumbar spine X-rays for all periods. Skin doses for all skin areas were determined according to the 

method described in ORAUT-OTIB-0006 (ORAUT 2011a) and are listed in Tables 3-5 through 3-8.

3.5 UNCERTAINTY

ORAUT-OTIB-0006 (ORAUT 2011a) lists the major sources of uncertainty in X-ray output intensity 

and subsequent effect on dose to the worker. The five sources of uncertainty are

1. X-ray beam measurement error (±2%),

2. Variation in peak kilovoltage (±9%),

3. Variation in X-ray beam current (±5%),

4. Variation in exposure time (±25%), and
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 10 of 21

5. Variation in source-to-skin distance 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 from differences of standard chest thickness of ±7.5 cm.

These uncertainties are assumed to be random; therefore, the combined statistical uncertainty was 

calculated as the square root of the sum of the squares of all the uncertainties, which is ±28.9%. 

Rounding this up to ±30% provides an adequate and suitably conservative indication of uncertainty.

Therefore, for a derived dose equivalent to an individual organ, a total combined standard uncertainty 

of ±30% can be assumed. Dose reconstructors should, therefore, input the organ dose equivalent as 

the mean of a normal distribution with a standard uncertainty of ±30%.

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

Organ Projection

PFG,

1951–1957a

14- × 17-in.,

1951–1974b

14- × 17-in.,

1975–1995

14- × 17-in.,

1996–present

Thyroid PA 3.94E–01 3.48E–02 1.85E–03 1.56E-03

LAT/OBL --c 6.85E–02 2.09E–02 9.52E-03

Eye/brain PA 7.25E–02 6.40E–03 1.85E–03 1.56E-03

LAT/OBL -- 6.85E–02 2.09E–02 9.52E-03

Ovaries PA 2.50E–02 2.50E–02 9.57E–05 8.07E-05

LAT/OBL -- 1.30E–02 2.22E–04 1.01E-04

Urinary/bladder/prostate PA 2.50E–02 2.50E–02 9.57E–05 8.07E-05

LAT/OBL -- 1.30E–02 2.22E–04 1.01E-04

Colon/rectum PA 2.50E–02 2.50E–02 9.57E–05 8.07E-05

LAT/OBL -- 1.30E–02 2.22E–04 1.01E-04

Testes PA 5.00E–03 5.00E–03 2.99E–07 2.52E-07

LAT/OBL -- 2.50E–03 1.39E–05 6.31E-06

Lungs (male) PA 9.50E–01 8.38E–02 1.69E–02 1.43E-02

LAT/OBL -- 9.65E–02 3.82E–02 1.74E-02

Lungs (female) PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Thymus PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Esophagus PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Stomach PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Bone surface PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Liver/gall bladder/

spleen/pancreas

PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Remainder organs PA 1.02E+00 9.02E–02 1.82E–02 1.54E-02

LAT/OBL -- 1.10E–01 4.30E–02 1.96E-02

Breast PA 1.11E–01 9.80E–03 2.72E–03 2.30E-03

LAT/OBL -- 1.28E–01 4.38E–02 1.99E-02

Uterus PA 2.50E–02 2.50E–02 8.79E–05 7.57E-05

LAT/OBL -- 1.30E–02 1.94E–04 8.83E-05

Bone marrow (male) PA 2.09E–01 1.84E–02 4.37E–03 3.68E-03

LAT/OBL -- 1.85E–02 8.45E–03 3.85E-03

Bone marrow (female) PA 1.95E–01 1.72E–02 4.22E–03 3.56E-03

LAT/OBL -- 1.45E–02 6.65E–03 3.03E-03

Entrance skind PA 3.06E+00 2.70E–01 4.19E–02 3.53E-02

LAT/OBL -- 6.75E–01 1.94E–01 8.83E-02

a. Doses for PFG are from ORAUT-OTIB-0006 (ORAUT 2011a) and assumed to be stereo views.
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 11 of 21

b. Doses before 1975 are based on values in ORAUT-OTIB-0006 (ORAUT 2011a).

c. -- = not applicable.

d. Entrance skin dose (ENSD) is determined by multiplying the incident air kerma by the backscatter factors of 1.35 and 

1.4 for HVL of 2.5 and 3.5 mm Al, respectively, from NCRP Report 102 (NCRP 1997, Table B-8). Skin doses for all 

areas of skin are provided in Tables 3-5 to 3-8 below.

Table 3-4. Organ dose equivalents (rem) for lumbar spine projections for all periods.

Organ

AP lumbar 

spine 

projection,

1951–1974a

LAT 

lumbar 

spine 

projection,

1951–1974a

AP lumbar 

spine 

projection,

1975–1980a

LAT 

lumbar 

spine 

projection,

1975–1980a

Thyroid 2.88E–04 3.79E–05 2.73E–04 3.48E–05

Eye/brain 2.88E–04 3.79E–05 2.73E–04 3.48E–05

Ovaries 5.60E–01 7.10E–01 1.97E–01 1.64E–01

Urinary/bladder/prostate 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Colon/rectum 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Testes 2.70E–02 5.60E–02 3.82E–03 2.78E–03

Lungs male 8.93E–02 3.79E–02 7.19E–02 4.87E–02

Lungs female 8.93E–02 3.79E–02 7.19E–02 4.87E–02

Thymus 8.93E–02 3.79E–02 7.19E–02 4.87E–02

Esophagus 8.93E–02 3.79E–02 7.19E–02 4.87E–02

Stomach 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Bone surfaces 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Liver/gall bladder/spleen/pancreas 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Remainder 2.30E–01 1.17E–01 1.97E–01 1.64E–01

Breast 4.78E–03b 7.58E–03b 9.56E–04b 2.07E–03b

Uterus 3.12E–01 7.58E–02 2.61E–01 1.08E–01

Bone marrow male 3.46E–02 5.69E–02 3.37E–02 7.66E–02

Bone marrow female 3.46E–02 5.69E–02 3.37E–02 7.66E–02

Entrance skin 1.90E+00 5.00E+00 1.20E+00 4.59E+00

a. From ORAUT-OTIB-0006 (ORAUT 2011a).

b. Using method described in ORAUT-OTIB-0006 (ORAUT 2011a).
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Table 3-5. Skin dose guidance and skin dose equivalents (rem) for chest projections, 1951 – 1974.

Area of skin

PFG 1951–1957 PA chest 1951–1974 LAT chest 1951–1974 RAO chest 1951–1974

Guidance Dose Guidance Dose Guidance Dose Guidance Dose

Right front shoulder EXSD 6.67E–02 EXSD 5.9E–03 ENSD 6.75E–01 EXSD 3.0E–03

Right back shoulder ENSD 3.06E+00 ENSD 2.70E–01 ENSD 6.75E–01 ENSD 6.75E–01

Left front shoulder EXSD 6.67E–02 EXSD 5.9E–03 EXSD 3.0E–03 EXSD 3.0E–03

Left back shoulder ENSD 3.06E+00 ENSD 2.70E–01 EXSD 3.0E–03 ENSD 6.75E–01

Right upper arm to elbow 10% ENSD 3.06E–01 ENSD 2.70E–01 ENSD 6.75E–01 ENSD 6.75E–01

Left upper arm to elbow 10% ENSD 3.06E–01 ENSD 2.70E–01 EXSD 3.0E–03 ENSD 6.75E–01

Left hand ENSD 3.06E+00 ENSD 2.70E–01 10% ENSD 6.75E–02 10% ENSD 6.75E–02

Right hand ENSD 3.06E+00 ENSD 2.70E–01 10% ENSD 6.75E–02 10% ENSD 6.75E–02

Left elbow, forearm, wrist 10% ENSD 3.06E–01 ENSD 2.70E–01 10% ENSD 6.75E–02 10% ENSD 6.75E–02

Right elbow, forearm, wrist 10% ENSD 3.06E–01 ENSD 2.70E–01 10% ENSD 6.75E–02 10% ENSD 6.75E–02

Right side of head (including ear 

and temple)

10% ENSD 3.06E–01 10% ENSD 2.70E–02 Eye/brain 6.85E–02 10% EXSD 3.E–04

Left side of head (including ear 

and temple)

10% ENSD 3.06E–01 10% ENSD 2.70E–02 Eye/brain 6.85E–02 10% ENSD 6.75E–02

Front left thigh RSD (0.52 m) 9.E–04 RSD (0.52 m) 8.E–05 RSD (0.52 m) 9.E–05 RSD (0.52 m) 9.E–05

Back left thigh RSD (0.52 m) 9.E–04 RSD (0.52 m) 8.E–05 RSD (0.52 m) 9.E–05 RSD (0.52 m) 9.E–05

Front right thigh RSD (0.52 m) 9.E–04 RSD (0.52 m) 8.E–05 RSD (0.52 m) 9.E–05 RSD (0.52 m) 9.E–05

Back right thigh RSD (0.52 m) 9.E–04 RSD (0.52 m) 8.E–05 RSD (0.52 m) 9.E–05 RSD (0.52 m) 9.E–05

Left knee and below RSD (0.86 m) 3.E–04 RSD (0.86 m) 3.E–05 RSD (0.86 m) 3.E–05 RSD (0.86 m) 3.E–05

Right knee and below RSD (0.86 m) 3.E–04 RSD (0.86 m) 3.E–05 RSD (0.86 m) 3.E–05 RSD (0.86 m) 3.E–05

Left side of face Eye/brain 7.25E–02 Eye/brain 6.4E–03 Eye/brain 6.85E–02 ENSD 6.75E–01

Right side of face Eye/brain 7.25E–02 Eye/brain 6.4E–03 Eye/brain 6.85E–02 EXSD 3.0E–03

Left side of neck 10% ENSD 3.06E–01 ENSD 2.70E–01 Eye/brain 6.85E–02 ENSD 6.75E–01

Right side of neck 10% ENSD 3.06E–01 ENSD 2.70E–01 Eye/brain 6.85E–02 EXSD 3.0E–03

Back of head 10% ENSD 3.06E–01 10% ENSD 2.70E–02 Eye/brain 6.85E–02 10% ENSD 6.75E–02

Front of neck Eye/brain 7.25E–02 Eye/brain 6.4E–03 Eye/brain 6.85E–02 Eye/Brain 6.85E–02

Back of neck 10% ENSD 3.06E–01 ENSD 2.70E–01 Eye/brain 6.85E–02 ENSD 6.75E–01

Front torso: base of neck to end 

of sternum

EXSD 6.67E–02 EXSD 5.9E–03 Lung 1.10E–01 EXSD 3.0E–03

Front torso: end of sternum to 

lowest rib

EXSD 6.67E–02 EXSD 5.9E–03 Lung 1.10E–01 EXSD 3.0E–03

Front torso: lowest rib to iliac 

crest

EXSD 6.67E–02 EXSD 5.9E–03 Lung 1.10E–01 EXSD 3.0E–03

Front torso: iliac crest to pubis 10% EXSD 6.7E–03 10% EXSD 6.E–04 10% lung 1.10E–02 10% EXSD 3.E–04

Back torso: base of neck to mid–

back

ENSD 3.06E+00 ENSD 2.70E–01 Lung 1.10E–01 ENSD 6.75E–01

Back torso: mid–back to lowest 

rib

ENSD 3.06E+00 ENSD 2.70E–01 Lung 1.10E–01 ENSD 6.75E–01
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Area of skin

PFG 1951–1957 PA chest 1951–1974 LAT chest 1951–1974 RAO chest 1951–1974

Guidance Dose Guidance Dose Guidance Dose Guidance Dose

Back torso: lowest rib to iliac 

crest

ENSD 3.06E+00 ENSD 2.70E–01 Lung 1.10E–01 ENSD 6.75E–01

Back torso: buttocks (Iliac crest 

and below)

10% ENSD 3.06E–01 10% ENSD 2.70E–02 10% Lung 1.10E–02 10% ENSD 6.75E–02

Right torso: base of neck to end 

of sternum

ENSD 3.06E+00 ENSD 2.70E–01 ENSD 6.75E–01 EXSD 3.0E–03

Right torso: end of sternum to 

lowest rib

ENSD 3.06E+00 ENSD 2.70E–01 ENSD 6.75E–01 EXSD 3.0E–03

Right torso: lowest rib to iliac 

crest

ENSD 3.06E+00 ENSD 2.70E–01 ENSD 6.75E–01 EXSD 3.0E–03

Right torso: iliac crest to pubis 

(right hip)

10% ENSD 3.06E–01 10% ENSD 2.70E–02 10% ENSD 6.75E–02 10% EXSD 3.E–04

Left torso: base of neck to end of 

sternum

ENSD 3.06E+00 ENSD 2.70E–01 EXSD 3.0E–03 ENSD 6.75E–01

Left torso: end of sternum to 

lowest rib

ENSD 3.06E+00 ENSD 2.70E–01 EXSD 3.0E–03 ENSD 6.75E–01

Left torso: lowest rib to iliac crest ENSD 3.06E+00 ENSD 2.70E–01 EXSD 3.0E–03 ENSD 6.75E–01

Left torso: iliac crest to pubis (left 

hip)

10% ENSD 3.06E–01 10% ENSD 2.70E–02 10% EXSD 3.E–04 10% ENSD 6.75E–02

Table 3-6. Skin dose guidance and skin dose equivalents (rem) for chest projections, 1975 – 1995.

Area of skin

PA chest, 1975–1995 LAT chest, 1975–1995 RAO chest, 1975–1995

Guidance Dose Guidance Dose Guidance Dose

Right front shoulder EXSD 1.2E-03 ENSD 1.94E-01 EXSD 1.2E-03

Right back shoulder ENSD 4.19E-02 ENSD 1.94E-01 ENSD 1.94E-01

Left front shoulder EXSD 1.2E-03 EXSD 1.2E-03 EXSD 1.2E-03

Left back shoulder ENSD 4.19E-02 EXSD 1.2E-03 ENSD 1.94E-01

Right upper arm to elbow 10% ENSD 4.2E-03 ENSD 1.94E-01 10% ENSD 1.94E-02

Left upper arm to elbow 10% ENSD 4.2E-03 EXSD 1.2E-03 10% ENSD 1.94E-02

Left hand 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Right hand 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Left elbow, forearm, wrist 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Right elbow, forearm, wrist 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Right side of head (including ear and temple) 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% EXSD 1.E-04

Left side of head (including ear and temple) 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Front left thigh RSD (0.52 m) 2.E-05 RSD (0.52 m) 4.E-05 RSD (0.52 m) 4.E-05

Back left thigh RSD (0.52 m) 2.E-05 RSD (0.52 m) 4.E-05 RSD (0.52 m) 4.E-05

Front right thigh RSD (0.52 m) 2.E-05 RSD (0.52 m) 4.E-05 RSD (0.52 m) 4.E-05

Back right thigh RSD (0.52 m) 2.E-05 RSD (0.52 m) 4.E-05 RSD (0.52 m) 4.E-05
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Area of skin

PA chest, 1975–1995 LAT chest, 1975–1995 RAO chest, 1975–1995

Guidance Dose Guidance Dose Guidance Dose

Left knee and below RSD (0.86 m) 6.E-06 RSD (0.86 m) 1.E-05 RSD (0.86 m) 1.E-05

Right knee and below RSD (0.86 m) 6.E-06 RSD (0.86 m) 1.E-05 RSD (0.86 m) 1.E-05

Left side of face Eye/brain 1.9E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Right side of face Eye/brain 1.9E-03 10% ENSD 1.94E-02 10% EXSD 1.E-04

Left side of neck 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Right side of neck 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% EXSD 1.E-04

Back of head 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Front of neck Thyroid 1.9E-03 10% ENSD 1.94E-02 Thyroid 2.09E-02

Back of neck 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% ENSD 1.94E-02

Front torso: base of neck to end of sternum EXSD 1.2E-03 Lung 4.30E-02 EXSD 1.2E-03

Front torso: end of sternum to lowest rib EXSD 1.2E-03 Lung 4.30E-02 EXSD 1.2E-03

Front torso: lowest rib to iliac crest 10% EXSD 1.E-04 10% Lung 4.3E-03 10% EXSD 1.E-04

Front torso: iliac crest to pubis 10% EXSD 1.E-04 10% Lung 4.3E-03 10% EXSD 1.E-04

Back torso: base of neck to mid–back ENSD 4.19E-02 Lung 4.30E-02 ENSD 1.94E-01

Back torso: mid–back to lowest rib ENSD 4.19E-02 Lung 4.30E-02 ENSD 1.94E-01

Back torso: lowest rib to iliac crest 10% ENSD 4.2E-03 10% lung 4.3E-03 10% ENSD 1.94E-02

Back torso: buttocks (Iliac crest and below) 10% ENSD 4.2E-03 10% lung 4.3E-03 10% ENSD 1.94E-02

Right torso: base of neck to end of sternum ENSD 4.19E-02 ENSD 1.94E-01 EXSD 1.2E-03

Right torso: end of sternum to lowest rib ENSD 4.19E-02 ENSD 1.94E-01 EXSD 1.2E-03

Right torso: lowest rib to iliac crest 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% EXSD 1.E-04

Right torso: iliac crest to pubis (right hip) 10% ENSD 4.2E-03 10% ENSD 1.94E-02 10% EXSD 1.E-04

Left torso: base of neck to end of sternum ENSD 4.19E-02 EXSD 1.2E-03 ENSD 1.94E-01

Left torso: end of sternum to lowest rib ENSD 4.19E-02 EXSD 1.2E-03 ENSD 1.94E-01

Left torso: lowest rib to iliac crest 10% ENSD 4.2E-03 10% EXSD 1.E-04 10% ENSD 1.94E-02

Left torso: iliac crest to pubis (left hip) 10% ENSD 4.2E-03 10% EXSD 1.E-04 10% ENSD 1.94E-02

Table 3-7. Skin dose guidance and skin dose equivalents (rem) for chest projections, 1996 – present.

Area of skin

PA chest, 1996–present LAT chest, 1996–present RAO chest, 1996–present

Guidance Dose Guidance Dose Guidance Dose

Right front shoulder EXSD 1.0E-03 ENSD 8.83E-02 EXSD 5.E-04

Right back shoulder ENSD 3.53E-02 ENSD 8.83E-02 ENSD 8.83E-02

Left front shoulder EXSD 1.0E-03 EXSD 5.E-04 EXSD 5.E-04

Left back shoulder ENSD 3.53E-02 EXSD 5.E-04 ENSD 8.83E-02

Right upper arm to elbow 10% ENSD 3.5E-03 ENSD 8.83E-02 10% ENSD 8.8E-03

Left upper arm to elbow 10% ENSD 3.5E-03 EXSD 5.E-04 10% ENSD 8.8E-03

Left hand 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Right hand 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Left elbow, forearm, wrist 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Right elbow, forearm, wrist 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03
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Area of skin

PA chest, 1996–present LAT chest, 1996–present RAO chest, 1996–present

Guidance Dose Guidance Dose Guidance Dose

Right side of head (including ear and temple) 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% EXSD 5.E-05

Left side of head (including ear and temple) 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Front left thigh RSD (0.52 m) 1.E-05 RSD (0.52 m) 2.E-05 RSD (0.52 m) 2.E-05

Back left thigh RSD (0.52 m) 1.E-05 RSD (0.52 m) 2.E-05 RSD (0.52 m) 2.E-05

Front right thigh RSD (0.52 m) 1.E-05 RSD (0.52 m) 2.E-05 RSD (0.52 m) 2.E-05

Back right thigh RSD (0.52 m) 1.E-05 RSD (0.52 m) 2.E-05 RSD (0.52 m) 2.E-05

Left knee and below RSD (0.86 m) 5.E-06 RSD (0.86 m) 6.E-06 RSD (0.86 m) 6.E-06

Right knee and below RSD (0.86 m) 5.E-06 RSD (0.86 m) 6.E-06 RSD (0.86 m) 6.E-06

Left side of face Eye/brain 1.56E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Right side of face Eye/brain 1.56E-03 10% ENSD 8.8E-03 10% EXSD 5.E-05

Left side of neck 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Right side of neck 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% EXSD 5.E-05

Back of head 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Front of neck Thyroid 1.56E-03 10% ENSD 8.8E-03 Thyroid 9.5E-03

Back of neck 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% ENSD 8.8E-03

Front torso: base of neck to end of sternum EXSD 1.0E-03 Lung 1.96E-02 EXSD 5.E-04

Front torso: end of sternum to lowest rib EXSD 1.0E-03 Lung 1.96E-02 EXSD 5.E-04

Front torso: lowest rib to iliac crest 10% EXSD 1.E-04 10% Lung 2.0E-03 10% EXSD 5.E-05

Front torso: iliac crest to pubis 10% EXSD 1.E-04 10% Lung 2.0E-03 10% EXSD 5.E-05

Back torso: base of neck to mid–back ENSD 3.53E-02 Lung 1.96E-02 ENSD 8.83E-02

Back torso: mid–back to lowest rib ENSD 3.53E-02 Lung 1.96E-02 ENSD 8.83E-02

Back torso: lowest rib to iliac crest 10% ENSD 3.5E-03 10% lung 2.0E-03 10% ENSD 8.8E-03

Back torso: buttocks (Iliac crest and below) 10% ENSD 3.5E-03 10% lung 2.0E-03 10% ENSD 8.8E-03

Right torso: base of neck to end of sternum ENSD 3.53E-02 ENSD 8.83E-02 EXSD 5.E-04

Right torso: end of sternum to lowest rib ENSD 3.53E-02 ENSD 8.83E-02 EXSD 5.E-04

Right torso: lowest rib to iliac crest 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% EXSD 5.E-05

Right torso: iliac crest to pubis (right hip) 10% ENSD 3.5E-03 10% ENSD 8.8E-03 10% EXSD 5.E-05

Left torso: base of neck to end of sternum ENSD 3.53E-02 EXSD 5.E-04 ENSD 8.83E-02

Left torso: end of sternum to lowest rib ENSD 3.53E-02 EXSD 5.E-04 ENSD 8.83E-02

Left torso: lowest rib to iliac crest 10% ENSD 3.5E-03 10% EXSD 5.E-05 10% ENSD 8.8E-03

Left torso: iliac crest to pubis (left hip) 10% ENSD 3.5E-03 10% EXSD 5.E-05 10% ENSD 8.8E-03

Table 3-8. Skin dose guidance and skin dose equivalents (rem) for lumbar spine projections, 1951 – 1979.

Area of skin

AP lumbar spine,

1951–1974

LAT lumbar spine,

1951–1974

AP lumbar spine,

1975–1979

LAT lumbar spine,

1975–1979

Guidance Dose Guidance Dose Guidance Dose Guidance Dose

Right front shoulder 10% ENSD 1.90E-01 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01

Right back shoulder 10% EXSD 3.6E-03 10% ENSD 5.00E-01 10% EXSD 2.6E-03 10% ENSD 4.59E-01

Left front shoulder 10% ENSD 1.90E-01 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03
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Area of skin

AP lumbar spine,

1951–1974

LAT lumbar spine,

1951–1974

AP lumbar spine,

1975–1979

LAT lumbar spine,

1975–1979

Guidance Dose Guidance Dose Guidance Dose Guidance Dose

Left back shoulder 10% EXSD 3.6E-03 10% EXSD 1.90E-03 10% EXSD 2.6E-03 10% EXSD 2.0E-03

Right upper arm to elbow 10% ENSD 1.90E-01 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01

Left upper arm to elbow 10% ENSD 1.90E-01 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03

Left hand ENSD 1.90E+00 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03

Right hand ENSD 1.90E+00 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01

Left elbow, forearm, wrist ENSD 1.90E+00 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03

Right elbow, forearm, wrist ENSD 1.90E+00 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01

Right side of head (including ear 

and temple)

Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Left side of head (including ear and 

temple)

Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Front left thigh 10% ENSD 1.90E-01 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03

Back left thigh 10% EXSD 3.6E-03 10% EXSD 1.90E-03 10% EXSD 2.6E-03 10% EXSD 2.0E-03

Front right thigh 10% ENSD 1.90E-01 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01

Back right thigh 10% EXSD 3.6E-03 10% ENSD 5.00E-01 10% EXSD 2.6E-03 10% ENSD 4.59E-01

Left knee and below RSD (0.60 m) 4.E-04 RSD (0.60 m) 4.E-04 RSD (0.60 m) 3.E-04 RSD (0.60 m) 5.E-04

Right knee and below RSD (0.60 m) 4.E-04 RSD (0.60 m) 4.E-04 RSD (0.60 m) 3.E-04 RSD (0.60 m) 5.E-04

Left side of face Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Right side of face Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Left side of neck Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Right side of neck Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Back of head Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Front of neck Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Back of neck Eye/brain 3.E-04 Eye/brain 3.E-05 Eye/brain 3.E-04 Eye/brain 3.E-05

Front torso: base of neck to end of 

sternum

10% ENSD 1.90E-01 Lung 3.79E-02 10% ENSD 1.20E-01 Lung 4.87E-02

Front torso: end of sternum to 

lowest rib

ENSD 1.90E+00 Lung 3.79E-02 ENSD 1.20E+00 Lung 4.87E-02

Front torso: lowest rib to iliac crest ENSD 1.90E+00 Lung 3.79E-02 ENSD 1.20E+00 Lung 4.87E-02

Front torso: iliac crest to pubis ENSD 1.90E+00 Lung 3.79E-02 ENSD 1.20E+00 Lung 4.87E-02

Back torso: base of neck to mid–

back

10% EXSD 3.6E-03 Lung 3.79E-02 10% EXSD 2.6E-03 Lung 4.87E-02

Back torso: mid–back to lowest rib EXSD 3.64E-02 Lung 3.79E-02 EXSD 2.61E-02 Lung 4.87E-02

Back torso: lowest rib to iliac crest EXSD 3.64E-02 Lung 3.79E-02 EXSD 2.61E-02 Lung 4.87E-02

Back torso: buttocks (Iliac crest and 

below)

EXSD 3.64E-02 Lung 3.79E-02 EXSD 2.61E-02 Lung 4.87E-02

Right torso: base of neck to end of 

sternum

10% ENSD 1.90E-01 10% ENSD 5.00E-01 10% ENSD 1.20E-01 10% ENSD 4.59E-01
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Area of skin

AP lumbar spine,

1951–1974

LAT lumbar spine,

1951–1974

AP lumbar spine,

1975–1979

LAT lumbar spine,

1975–1979

Guidance Dose Guidance Dose Guidance Dose Guidance Dose

Right torso: end of sternum to 

lowest rib

ENSD 1.90E+00 ENSD 5.00E+00 ENSD 1.20E+00 ENSD 4.59E+00

Right torso: lowest rib to iliac crest ENSD 1.90E+00 ENSD 5.00E+00 ENSD 1.20E+00 ENSD 4.59E+00

Right torso: iliac crest to pubis 

(right hip)

ENSD 1.90E+00 ENSD 5.00E+00 ENSD 1.20E+00 ENSD 4.59E+00

Left torso: base of neck to end of 

sternum

10% ENSD 1.90E-01 10% EXSD 1.90E-03 10% ENSD 1.20E-01 10% EXSD 2.0E-03

Left torso: end of sternum to lowest 

rib

ENSD 1.90E+00 EXSD 1.90E-02 ENSD 1.20E+00 EXSD 2.02E-02

Left torso: lowest rib to iliac crest ENSD 1.90E+00 EXSD 1.90E-02 ENSD 1.20E+00 EXSD 2.02E-02

Left torso: iliac crest to pubis (left 

hip)

ENSD 1.90E+00 EXSD 1.90E-02 ENSD 1.20E+00 EXSD 2.02E-02
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3.6 ATTRIBUTIONS AND ANNOTATIONS

All information requiring identification was addressed via references integrated into the reference 

section of this document.
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 19 of 21

REFERENCES

Collins, B. B., 1988, “X-Ray Facility Survey,” letter to R. Rucker (Martin Marietta Energy Systems), 

Department of Health and Human Services, Public Health Service, Food and Drug 

Administration, Nashville District Office, Nashville, Tennessee, February 29. [SRDB Ref ID: 

75962, pp. 3-5]

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GLOSSARY

absorbed dose

Amount of energy (ergs or joules) deposited in a substance by ionizing radiation per unit mass 

(grams or kilograms) of the substance and measured in units of rads or grays. See dose.

kilovoltage (kVp) 

Electrical potential difference in units of kilovolts between the cathode and the anode in the Xray generating tube. See technique.

backscatter (radiation)

Reflection or refraction of radiation at angles over 90 degrees from its original direction.

beam quality 

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

the kilovoltage, anode material, voltage waveform, and filtration of an X-ray tube. The halfvalue layer in millimeters of aluminum is a typical measure of X-ray beam quality for the 

energy range used in radiography. See kilovoltage and filtration.

dose 

In general, the specific amount of energy from ionizing radiation that is absorbed per unit of 

mass. Effective and equivalent doses are in units of rem or sievert; other types of dose are in 

units of roentgens, rads, reps, or grays

dose conversion factor (DCF) 

Multiplier for conversion of potential dose to the personal dose equivalent to the organ of 

interest (e.g., liver or colon). In relation to radiography, ratio of dose equivalent in tissue or 

organ to incident air kerma at the surface of the skin of the X-rayed person.

dose equivalent

In units of rem or sievert, product of absorbed dose in tissue multiplied by a weighting factor 

and sometimes by other modifying factors to account for the potential for a biological effect 

from the absorbed dose. See dose.

filtration 

The process of filtering an X-ray beam, usually with millimeter thicknesses of aluminum 

material between the X-ray source and the image receptor that preferentially absorbs photons 

from the beam. Usually measured in equivalent millimeters of aluminum. See beam quality

and half-value layer.

gray (Gy)

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

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

100 rads.

half-value layer (HVL) 

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

attenuates an X-ray beam to one half the original kerma rate. See filtration. 

kerma

Measure in units of absorbed dose (usually grays but sometimes rads) of the energy released 

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

energies of all the charged ionizing particles liberated by uncharged ionizing particles 
Document No. ORAUT-TKBS-0019-3 Revision No. 03 Effective Date: 08/23/2012 Page 21 of 21

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

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

The word derives from kinetic energy released per unit mass.

rem

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

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

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

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

sievert (Sv)

International System unit for dose equivalent, which indicates the biological damage caused 

by radiation. The unit is the radiation value in gray (equal to 1 joule per kilogram) multiplied by 

a weighting factor for the type of radiation and a weighting factor for the tissue; 1 Sv equals 

100 rem.

source-to-skin distance (SSD) 

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

distance varies with the size of the person being radiographed. 

technique 

Combination of X-ray machine settings used to produce radiographs, which consists of the 

kilovoltage, tube current (milliamperes), and exposure time (seconds). The last two 

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

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

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

a fixed peak kilovoltage.

X-ray radiation 

Electromagnetic radiation (photons) produced by bombardment of atoms by accelerated 

particles. X-rays are produced by various mechanisms including bremsstrahlung and electron 

shell transitions within atoms (characteristic X-rays). Once formed, there is no difference 

between X-rays and gamma rays, but gamma photons originate inside the nucleus of an atom.