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Radiation Dose Reconstruction Program

Origins

Since World War II, many workers took part in nuclear weapons-related activities for the Department of Energy (DOE), its contractors and subcontractors, and Atomic Weapons Employers. Much of the work at these sites involved work with radiation and radioactive materials. Some of these workers developed cancer. Radiation exposures they received at the work site may be linked to their cancer.

In 2000, the President passed the Energy Employees Occupational Illness Compensation Program Act (the Act or EEOICPA) to help these workers. Part B of the Act requires that the Department of Labor (DOL) determine whether workers' potential exposure to certain types of radiation at a work site is linked to their cancer.

Part B also requires that the Department of Health and Human Services (HHS) support DOL by estimating workers’ past exposure to radiation (dose reconstruction). HHS gave this responsibility to the National Institute for Occupational Safety and Health (NIOSH).

NIOSH hired expert staff, conducted thorough research, and developed the formal guidelines and scientific methods needed to conduct dose reconstructions.

Overview of the Dose Reconstruction Process

DOL Sends the Case to NIOSH

The Department of Labor reviews claims to see if they are eligible for the program. The employee must have worked at a covered work site during a covered time period and have a qualifying health condition. If at least one of the health conditions in the case is cancer, DOL sends the case to NIOSH for dose reconstruction.

NIOSH Gathers Worker and Work Site Information

NIOSH gathers worker and work site information needed to complete the dose reconstruction. We make every attempt to account for all possible radiation exposure. We begin by asking DOE for worker and work site records and data. Each claimant can also speak with us about the worker's employment history (see Work History Phone Calls). The claimant may have information that can help us estimate radiation dose.

We also use technical documents which include Site Profiles, Technical Basis Documents, and Technical Information Bulletins. Technical documents provide a way to put together the large amount of site data. They provide instructions on how to prepare dose reconstructions consistently.

NIOSH Health Physicist Conducts the Dose Reconstruction

After gathering the worker and workplace data, we assign a Health Physicist (HP) to conduct the dose reconstruction. The HP estimates how much radiation dose the worker received at the cancer site.

The HP reviews the file carefully and based on the information in the claimant's file will:

  • Describe the exposure scenario which may include:
    • worker's activities in areas where they could have been exposed to radiation or radioactive materials
    • levels of worker exposure to radiation and radioactivity
    • description of the sources of radiation exposure
    • dose received from medical x-rays required as a condition of employment
  • Identify exposure pathways:
    • Document how the energy employee may have received external dose (radiation that comes from outside the body) or internal dose (radioactive material that gets inside the body when you breathe or ingest it)
  • Choose a method to estimate dose:
    • Choose methods well-grounded in the best available science
    • Choose the scenario most favorable to the claimant when two or more possible scenarios are equally probable
  • Evaluate uncertainties in the dose estimates:
    • Account for incomplete knowledge of the exposure scenario, variability in measurements, etc.
  • Present and interpret results in a dose reconstruction report:
    • Provide a draft dose reconstruction report to the claimant that describes the assumptions and methods used to estimate the worker's dose

NIOSH Sends the Claimant a Draft Dose Reconstruction Report

NIOSH completes the dose reconstruction and sends a draft dose reconstruction report to the claimant for review. We schedule a telephone call to discuss the methods used in the dose reconstruction and to ensure that the claimant has provided all relevant information.

The claimant then signs an OCAS-1 form. The form tells us the claimant does not have anything more to share at that time. It does not mean the claimant agrees with the dose reconstruction results.

NIOSH Sends the Dose Reconstruction Back to DOL for a Final Decision

After NIOSH receives the signed OCAS-1 form from the claimant, we send the dose reconstruction to DOL for a compensation decision. DOL uses the results from our dose reconstruction to determine the likelihood that radiation exposures the worker received at the work site caused their cancer (see Probability of Causation).

Time to Complete Dose Reconstructions

We cannot predict how long each dose reconstruction will take to complete. No two are alike. It may take a significant amount of time to gather the information we need. The Department of Energy has a goal of 60 days to provide information needed for a specific case. They often beat this goal.

Our goal is to complete the dose reconstruction within 5 months once we have all the information we need. Over the past year we completed more than 90% of dose reconstructions in 5 months or less after receiving all necessary data.

Scientific Validity and Quality of NIOSH's Dose Reconstructions

Dose reconstruction began in the late 1970s and is a widely accepted practice used within the scientific community. It is an integral part of radiation illness compensation programs, both in the United States and internationally.

NIOSH shares technical information on dose reconstructions on our website. We give the public and the scientific community a chance to review and comment on the technical documents used to complete dose reconstructions.

The Advisory Board on Radiation and Worker Health (the Board) also reviews NIOSH dose reconstructions for scientific validity and quality. The Board is an independent federal advisory committee that represents scientific, medical, and worker perspectives. It also assesses the dose reconstruction methods used.

NIOSH responds to comments and recommendations. We often revise the technical documents used in dose reconstruction. We review denied claims possibly affected by these revisions to determine if the change could result in compensability. NIOSH asks DOL to return affected cases and revises them based on the new or updated information. We report the results in a Program Evaluation Report (PER) on our website. The PER details the effect, if any, of the new information on the dose reconstruction process.

Our quality assurance (QA) and quality control (QC) programs also ensure our organizational structure, procedures, processes, and resources result in valid dose reconstructions. The QA/QC process begins as soon as we receive a cancer case from DOL for dose reconstruction and continues until we return the case to DOL for a compensation decision.

NIOSH updates the scientific elements of the dose reconstruction program as needed. This ensures our methods are reasonably current with scientific progress. Updates may also be recommended by the public at any time.

 
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