dose and the “high-sided” inhalation dose will result in a high-sided estimate of the 95th percentile upper bound of the total organ dose.³³ Although external and inhalation dose estimates are sometimes correlated to some extent, such as when both are based on the same exposure-rate measurement, most of the pertinent uncertainties involved are independent of each other. The estimated beta skin dose calculated by the NTPR program is directly related to the reported upper bound in gamma external dose. Thus, summing the reported beta dose estimate with the reported upper-bound gamma dose estimate will result in a credible estimate of the upper bound of the skin dose when the beta and gamma dose estimates both are credible upper bounds.

The committee acknowledges that calculation of an upper-bound dose is itself an uncertain process. Furthermore, it is not clear how one ought to quantify effects of uncertainties in an activity scenario. For example, for external radiation exposure, NTPR program policy guidelines sometimes seem to target a best or even “high-sided” central estimate together with a 95th percentile upper-bound dose, and at other times seem to opt for only a “high-sided” estimate, in accordance with the benefit-of-the-doubt provision. For internal dose, the policy of the NTPR program is to provide a “high-sided” estimate that supposedly incorporates benefit of the doubt with respect to the exposure scenario. However, as discussed elsewhere in this chapter, the committee has concluded that assumed exposure scenarios often did not give the veteran the benefit of the doubt.

The central (“best”) estimates of external gamma and neutron doses to participants obtained by the NTPR program based on film-badge data and/or unit dose reconstructions are generally credible, provided that the assumed exposure scenario is reasonable. However, the committee has documented numerous examples in which the NTPR program has failed to establish the participant’s exposure scenario adequately; that is, plausible scenarios could be developed, on the basis of available information, that would have resulted in higher estimates of dose.

The committee finds that estimates of uncertainty in external dose obtained by the NTPR program in unit dose reconstructions often are not credible and do not adequately reflect the upper bound (95th percentile) in the external dose to an individual participant, because deviations in individual exposure scenarios from the assumed group exposure scenario are not considered. Furthermore, the committee has identified a number of situations in which uncertainty in film-badge issuance dates, interpretation of data, and failure to give the veteran the benefit of