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Once a claim is filed under The Act, the Department of Labor (DOL) determines if the employee worked at a covered facility during a covered time period and has a qualifying health condition. If the health condition in the claim is cancer, the case is then sent to NIOSH for dose reconstruction. Dose reconstruction is the scientific process of estimating a worker's past exposure to radiation. It uses exposure monitoring and other information to determine what levels of radiation the workers were exposed to while they worked at a facility.
Once the dose reconstruction is completed by NIOSH, the case is returned to DOL. The information from the dose reconstruction is used by DOL to determine the probability that a worker's cancer was "at least as likely as not" due to the employee's occupational exposure to radiation during employment at a covered facility.
To answer questions about the dose reconstruction, NIOSH developed a list of Frequently Asked Questions (FAQs) below. Links to other program FAQs are located on the "Find It!" navigation box under "On this page . . . "
Select the question you are interested in below by clicking its link. You will be taken to the answer located on this page. Links throughout the FAQs will guide you to further information.
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Dose Reconstruction
- What is dose reconstruction?
Dose reconstruction is the scientific process of estimating
a worker's past exposure to radiation. It uses exposure
monitoring and other information to determine what levels
of radiation the workers were exposed to while they
worked at a facility.
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- What is the purpose
of dose reconstruction?
Dose reconstructions are used to estimate the radiation
doses to which an individual worker or group of workers
have been exposed. The information from the dose reconstruction
is used by DOL to determine the probability that a worker's
cancer was "at least as likely as not" due
to the employee's occupational exposure to radiation
during employment at a covered facility.
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- Does NIOSH conduct dose
reconstructions for workers who have been diagnosed
with illnesses other than cancer?
No. Under Subtitle B of The Act, NIOSH only conducts
dose reconstructions on workers who have been diagnosed
with cancer.
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- How can a worker or
survivor request an individual dose reconstruction?
Anyone wishing to file a claim will need to complete
DOL claims forms. These forms can be found under the
Claims Forms section of the DOL
EEOICP Web site.
External Link: http://www.dol.gov/esa/owcp/energy/index.htm
DOL will collect medical, employment, and other information
from the worker or survivor and make a decision about
whether or not he or she qualifies for compensation
and benefits.
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- What information is
needed to conduct a dose reconstruction?
We try to use personal exposure information whenever
possible. This would include film badge readings, x-rays,
urinalysis results, incident reports, etc. If there
is little or no personal exposure information, we use
information from technical documents
(e.g., technical basis documents, site profile documents,
technical information bulletins), and coworker data
to provide reasonable estimates of dose where the personal
exposure information is lacking.
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- Is there anything I
need to send to NIOSH to help with the dose reconstruction?
At the appropriate time, we will contact you to set
up a convenient date and time for a voluntary telephone
interview. That's a time we have put in our process
to ask you for information we might need. Prior to the
phone interview, if we need any additional information
from you, we will contact you. At any point in the process,
you are more than welcome to provide any information
which you may feel help your claim.
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- How will NIOSH complete
a dose reconstruction for a case when there is little
or no exposure monitoring information available?
If there is little or no personal exposure information,
we use information from technical
documents (e.g., technical basis documents, site
profile documents, technical information bulletins),
and data from other workers at the site to fill in the
areas where the personal exposure information is lacking.
The assumptions used in conducting dose reconstructions
are designed to give the claimant the benefit of the
doubt whenever estimated radiation dose levels are used.
Dose reconstruction could require extensive data gathering
and analysis. This may include:
- Determining specific characteristics
of the monitoring procedures
- Identifying events that
were unmonitored
- Identifying the types and
quantities of radioactive materials involved
- Evaluating production processes
and safety procedures
- Identifying the locations
and activities of exposed persons
- Identifying comparable exposure
circumstances for which data is available to make
assumptions
- Conducting a variety of
complex analyses to understand the data compiled
or estimated
- Utilizing cancer risk models*
*A cancer risk model is a mathematical
model based on the dose-response relationship determined
for a given cancer type and is used to estimate the
probability of causation (PC)
using information on radiation dose and personal data.
Cancer risk models and the amount of radiation dose
an energy employee was exposed to are the main determinants
of probability of causation. The cancer risk models
are based on the best science available and the radiation
dose levels are based mostly on very generous dose reconstruction
methods.
NIOSH may also use the following sources of information:
- Department of Energy (DOE)
and its contractors, including Atomic Weapons Employers
(AWEs) and the Former Worker Screening Program
- NIOSH and other records
from health research on DOE worker populations
- Interviews and records provided
by the claimant
- Co-workers of covered employees,
or other witnesses with information relevant to
the covered employee's exposure identified during
an interview with NIOSH
- Labor union records from
unions representing employees at covered facilities
of DOE or AWEs
- Other relevant information
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- How will a dose reconstruction
be done for my case?
NIOSH starts by collecting an initial set of records
from DOE and other sources that provide us with information
on your radiation exposures. These records may, or may
not, include personal monitoring of your radiation doses.
In addition, the records might also include area monitoring
of radiation levels and process descriptions that help
characterize the possible levels of radiation exposures,
the use of radiation protection measures, and the occurrence
of incidents involving unexpected radiation exposures.
The next step is to schedule a voluntary telephone
interview with you to try to identify information
that may not be found in the records we have collected.
After we have collected the information needed, we will
perform analysis that allows us to estimate the range
of radiation dose you may have been exposed to in your
workplace. This range will include the least radiation
you might have received and the most -- the "worst
case." We will report the estimates of your dose
with ranges that include the worst case to DOL.
Before we report these estimates, however, we will send
a copy of the dose
reconstruction draft report to you. We will review
the report with you, explaining in detail what records,
information, and criteria were used to produce the estimates
found in your dose reconstruction. This review will
enable you to help us ensure that we have taken into
account all you and others know about your exposures.
In addition, the review will also inform you of exactly
how we have done our work, so you can consider whether
we have fully addressed any concerns you might have.
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- How will I know when
my case is ready for dose reconstruction?
When your case is ready for dose reconstruction, we
will send a letter to you that provides information
about NIOSH's policy of selecting a Health Physicist
(s) to work on a dose reconstruction for a case. (See
Conflict of Interest Letter)
Please note that dose reconstructions cannot be started
until sufficient exposure information is collected.
Once our contractor has received enough information
to conduct the dose reconstruction for your case, your
case will be assigned to a Health Physicist.
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- How long does it take
to complete a dose reconstruction?
There are many steps necessary to complete each dose
reconstruction, and each step varies for each claim.
For example, obtaining the information to complete the
dose reconstruction estimate may take a significant
amount of time depending on the complexity and availability
of the data. Therefore, there is no way to predict how
long each claim may take to complete the dose reconstruction
process.
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- How many completed dose
reconstructions have been sent back to DOL?
For current numbers on cases returned to DOL for a decision,
please refer to the NIOSH Web site's Claim
Information page.
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- What if I remember additional
information that may be important to my dose reconstruction
after DOL has made a decision?
If you have additional information about your case after
DOL has made a decision, you can contact DOL and provide
them with the information. DOL will then decide whether
or not your case should be reopened.
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- What if I disagree with
the findings of the dose reconstruction?
We have worked hard to address the concerns of claimants
that might lead to disagreement. NIOSH fully involves
the claimant in the dose reconstruction process, makes
use of relevant information the claimant and others
bring to bear, and directly addresses the concerns we
know claimants have.
Claimants have the opportunity to participate in a closing
interview with NIOSH to review the dose reconstruction
results and the basis on which the results were calculated.
During the interview,
claimants can voice their disagreement with the findings
and provide any additional relevant information that
may affect the dose reconstruction or indicate that
they are in the process of obtaining such information.
In addition, the Advisory Board
on Radiation and Worker Health, an independent federal
advisory committee representing scientific, medical,
and worker perspectives, reviews samples of NIOSH dose
reconstructions to help ensure the quality of the program.
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- Why is the Advisory
Board on Radiation and Worker Health reviewing dose
reconstructions?
As The Act requires, the Advisory Board, an independent
federal advisory committee representing scientific,
medical, and worker perspectives, reviews NIOSH dose
reconstructions for scientific validity and accuracy.
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- How does the Advisory
Board on Radiation and Worker Health select dose reconstructions
to review?
The Advisory Board has established a system to assist
them in randomly selecting dose reconstructions for
review. The system they are using helps the Advisory
Board make sure that the random sample of cases selected
for review represents a variety of places of employment
and probability of causation values.
Please note: The Advisory Board does
not review cases which do not have a final decision
from DOL, and they do not handle cases based on appeals
of decisions.
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- How confident are you
and can the public be in the fairness of your methods
of dose reconstruction and for identifying cancers that
were caused by radiation?
The Act recognizes that we will be dealing with uncertainties
and limited data. We have used the best that science
has to offer to develop the methods and guidelines for
dose reconstruction and probability of causation. We
are confident these methods and guidelines are very
fair to workers.
To the extent that the science and data involve uncertainties,
these uncertainties are handled to the advantage rather
than to the disadvantage of the claims. To help ensure
that the methods and guidelines are as sound as possible,
we will also provide opportunity for full review and
comment on our work from the public and from the independent
Advisory Board on Radiation and
Worker Health.
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- What is the Methods
for Radiation Dose Reconstruction rule?
This rule describes the methods that the Department
for Health and Human Services/NIOSH will use to conduct
a dose reconstruction for your case. The purpose of
dose reconstruction is to characterize the occupational
radiation environment to which you were exposed.
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- Where can I find a copy
of the Methods for Radiation Dose Reconstruction rule?
You can find a copy of the Final Rule: Methods for Radiation
Dose Reconstruction under The Act - 42 CFR 82 on the
Dose Reconstruction page
of this Web site.
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- NIOSH completed my dose
reconstruction and DOL calculated the probability of
causation for my claim to be less than 50%. As a result,
DOL's recommended decision was to deny compensation
for my claim. I have subsequently had two additional
cancers. I reported the two additional cancers to DOL
and my case was returned to NIOSH for a new dose reconstruction.
NIOSH completed the new dose reconstruction using my
two additional cancers and when DOL determined my probability
of causation, it was again less than 50%. In fact, once
the two new cancers were added to my dose reconstruction,
the probability of causation percentage calculated by
DOL was lower than the value of my first dose reconstruction.
How is this possible? Shouldn't the addition of two
more cancers increase the probability of causation value?
NIOSH understands this concern. It may seem obvious
that when additional cancers are added to a dose reconstruction
it would increase the probability that radiation caused
the multiple cancers. However, in some cases, the NIOSH
dose reconstruction will result in a lower probability
of causation when additional cancers are added. An explanation
for how and why this can happen is as follows:
Accurately estimating the exposure a worker received
while working at a covered facility is a time consuming
process. In order to complete dose reconstructions in
as timely and efficient a manner as possible, NIOSH
may make assumptions on dose estimates that are favorable
to the claimant in order to simplify the dose reconstruction
process.
For instance, instead of completing a dose reconstruction
which precisely estimates the worker's exposure for
cases that would most likely result in a probability
of causation well below the 50% necessary for the claim
to be compensable by DOL, NIOSH will significantly over-estimate
the exposure based on the highest levels of exposure
observed or possible for the facility. If the claim
will not be compensable even when using these significantly
over-estimated exposure estimates, then no further refinement
to the dose reconstruction is required.
This manner of dose reconstruction is called an "efficiency
measure" because it allows NIOSH to issue a timely
dose reconstruction where attempts to refine the exposure
estimate would not result in a compensable claim (i.e.,
a full dose reconstruction would in all likelihood produce
a much lower probability of causation than the over-estimated
exposure values used).
Anytime a new cancer(s) is reported to NIOSH by DOL,
NIOSH is required to rework the dose reconstruction
to include the new cancer(s). If the new cancer(s) creates
a potentially compensable case, NIOSH must refine the
dose reconstruction using more probable and precise
exposure estimates and not the significant over-estimates
as mentioned above. These new, more accurate exposure
estimates will be lower than the original estimate because
we no longer use the assumptions which overestimated
the radiation dose for the cancer found in the initial
dose reconstruction. The revised radiation dose estimate
may result in a probability of causation for the new
cancer(s) that is lower than the non-compensable estimate
that was obtained for the first cancer using the over-estimated
radiation exposure. That is why the addition of a new
cancer(s) may result in a probability of causation that
is lower than the probability found for the single original
cancer. However, it is possible for additional cancer(s)
to produce a full dose reconstruction that will be determined
to be compensable by DOL.
The use of "efficiency measures" and procedures
for dose reconstructions that NIOSH follows under EEOICPA
are described in detail in Final Rule: Methods for Radiation
Dose Reconstruction under The Act--42 CFR 82.
- I've listened to some
of the discussions by NIOSH staff at public meetings
and heard them mention best estimates, overestimates,
underestimates and partial when talking about dose reconstructions.
Dose reconstruction is confusing enough but what do
all of these things mean? Are there different types
of dose reconstructions? If so, why and how do they
differ?
During many of our public meetings, we have had discussions
on the different methods we use to complete dose reconstructions
under EEOICPA. During these discussions, you may have
heard the terms best estimate, overestimate, underestimate,
and at times, even partial dose reconstruction. All
refer to the method that was used for completing the
dose reconstruction.
As an accepted scientific method, dose reconstruction
provides an estimate of an employee's past work-related
exposure to radiation, particularly when radiation monitoring
data are unavailable, incomplete, or of poor quality.
If we lived in a perfect world, dose reconstruction
would not exist because we would have a complete record
of each employee's radiation exposure for every minute
of their employment history. Therefore, there would
be no need to estimate radiation exposures because the
exact radiation exposure would be present in the records.
Unfortunately this does not exist and we use dose reconstruction
methods to estimate exposure to radiation. Because these
dose reconstructions are being completed as part of
a compensation program, NIOSH uses efficiency methods
and measures to complete dose reconstruction in as timely
a manner as possible.
The efficiency process employed by NIOSH is designed
to allow for an accurate compensation decision by the
Department of Labor, while minimizing the amount of
time spent reconstructing a dose. Before starting the
dose reconstruction, NIOSH conducts a preliminary review
and makes a professional judgment of an energy employee's
potential radiation exposure based on the findings of
similar dose reconstructions to determine the proper
dose reconstruction method to use. The different methods
used to complete dose reconstructions are underestimate,
overestimate, best estimate, and a partial (but complete)
dose reconstruction.
Underestimate -- The claim was processed
using a conservatively low estimate of the worker's
dose and was found to result in a probability of causation
value that was equal to or exceeded 50%. This method
does not necessarily include all of the workers' radiation
dose data and is most appropriate for workers with high
exposures or a cancer likely to be caused by radiation
exposure (e.g., leukemia). NIOSH tests the assumption
that probability of causation value is >50%
by giving the energy employee the lowest likely dose.
If the probability of causation value is still >50%,
no further evaluation is required. If this method results
in a probability of causation value <50%, NIOSH
will refine the calculation (e.g., include more dose)
toward a best estimate. If the probability of causation
value remains <50%, another efficiency method
must be used.
Overestimate -- The claim was processed
using plausible, worst-case assumptions for the worker's
dose (i.e., the maximum plausible dose) and was found
to result in a probability of causation value that was
less than 50%. The dose estimate is much higher
than what the energy employee received. An overestimate
efficiency method may be used for an energy employee
that had a very short duration of employment at a covered
facility or was diagnosed with a cancer that is not
a cancer likely to be caused by radiation exposure (e.g.,
prostate cancer). NIOSH tests this assumption by giving
the energy employee the maximum plausible dose. If the
probability of causation value is still <50%,
no further evaluation is required. However, if this
method results in a probability of causation value >50%,
another dose reconstruction method must be used.
Best Estimate -- A dose reconstruction
performed using the complete set of data and information
available to NIOSH and using reasonable claimant favorable
assumptions.
Partial Dose Reconstruction -- NIOSH
conducts partial dose reconstructions for cases where
an SEC class of employees has been designated, but the
case does not meet criteria for compensation under the
SEC. The energy employee may not have one of the qualifying
cancers listed for the SEC and/or does not meet the
employment criteria of the SEC class and therefore,
a dose reconstruction must be completed for the claim.
For cases in this situation, the addition of the SEC
class was determined because some data was unusable
in dose reconstruction and therefore, NIOSH can only
reconstruct a portion of the dose. This type of dose
reconstruction is complete and serves as a best estimate
given that all reliable data available was used.
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Page last updated: February 3, 2009
Page last reviewed: June 9, 2009
Content Source: National Institute for Occupational Safety and Health (NIOSH)
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