A REVIEW OF THE DOSE RECONSTRUCTION PROGRAM OF THE DEFENSE THREAT REDUCTION AGENCY

Committee to Review the Dose Reconstruction Program of the Defense Threat Reduction Agency

Board on Radiation Effects Research

Division on Earth and Life Studies

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
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A REVIEW OF THE DOSE RECONSTRUCTION PROGRAM OF THE DEFENSE THREAT REDUCTION AGENCY Committee to Review the Dose Reconstruction Program of the Defense Threat Reduction Agency Board on Radiation Effects Research Division on Earth and Life Studies NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by contract DTRA01-01-C-0012 between the National Academy of Sciences and the Defense Threat Reduction Agency. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-08902-6 (Book) International Standard Book Number 0-309-51696-X (PDF) Library of Congress Control Number 2003094456 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu COVER PHOTO. Soldiers watching atomic-bomb detonation at Yucca Flat, Nevada. This photo is Shot DOG in which a 21.5-kiloton device was dropped from a B-50 bomber in the BUSTER-JANGLE series of tests on November 1, 1951. This photo was also published in the November 12, 1951, issue of Life Magazine. Copyright 2003 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

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THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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COMMITTEE TO REVIEW THE DOSE RECONSTRUCTION PROGRAM OF THE DEFENSE THREAT REDUCTION AGENCY (DTRA) JOHN E. TILL (Chairman), President, Risk Assessment Corporation, Neeses, SC HAROLD L. BECK, Environmental Measurements Laboratory (ret.), New York, NY WILLIAM J. BRADY, Reynolds Electrical and Engineering Co., Inc. (ret.), Las Vegas, NV THOMAS F. GESELL, Idaho State University, Pocatello, ID DAVID G. HOEL, Medical University of South Carolina, Charleston, SC ERIC E. KEARSLEY (Member until 12/10/2001), Silver Spring, MD DAVID C. KOCHER, SENES Oak Ridge Inc., Oak Ridge, TN JONATHAN D. MORENO, University of Virginia, Charlottesville, VA CLARICE R. WEINBERG, National Institute of Environmental Health Sciences, Research Triangle Park, NC NATIONAL RESEARCH COUNCIL STAFF EVAN B. DOUPLE, Director, Board on Radiation Effects Research ISAF AL-NABULSI, Study Director DIANNE STARE, Research Assistant DORIS E. TAYLOR, Staff Assistant NORMAN GROSSBLATT, Senior Editor SPONSOR’S PROJECT OFFICER D. MICHAEL SCHAEFFER, Defense Threat Reduction Agency

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BOARD ON RADIATION EFFECTS RESEARCH S. JAMES ADELSTEIN (Chairman), Harvard Medical School, Boston, MA R. J. MICHAEL FRY (chairman until 6/30/02), Indianapolis, IN JOEL S. BEDFORD, Colorado State University, Fort Collins, CO VALERIE BERAL, University of Oxford, United Kingdom JAMES E. CLEAVER, UCSF Cancer Center, San Francisco, CA SARAH S. DONALDSON, Stanford University Medical Center, Stanford, CA SHARON L. DUNWOODY, University of Wisconsin, Madison, WI EDWARD R. EPP, Professor Emeritus, Harvard University, Boston, MA HELEN H. EVANS (member until 6/30/02), Case Western Reserve University, Cleveland, OH DANIEL KREWSKI, University of Ottawa, Ottawa, Canada WILLIAM F. MORGAN, University of Maryland, Baltimore, MD THEODORE L. PHILLIPS, University of California, San Francisco, CA FRANKLYN G. PRENDERGAST, Mayo Clinic Cancer Center, Rochester, MN ANDREW M. SESSLER, Lawrence Berkeley National Laboratory, Berkeley, CA DANIEL O. STRAM, University of Southern California, Los Angeles, CA PAUL L. ZEIMER, Purdue University, West Lafayette, IN NATIONAL RESEARCH COUNCIL STAFF EVAN B. DOUPLE, Director, Board on Radiation Effects Research ISAF AL-NABULSI, Senior Program Officer RICK JOSTES, Senior Program Officer CATHERINE S. BERKLEY, Administrative Associate TAJUANA CLAYTON, Project Assistant BENJAMIN HAMLIN, Research Assistant (until 12/13/02) DIANNE STARE, Research Assistant DORIS E. TAYLOR, Staff Assistant

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A Note on the Units of Measurement Used in this Report It has been the custom of the Board on Radiation Effects Research (BRER) to use the International System of Units (SI) in its reports. In this report, however, exceptions are made in presenting data on radiation exposure, radiation dose, and activity of radionuclides. In all such cases, traditional non-SI units and their special names are used. Thus, exposure in air is given in roentgen (R), absorbed dose in rad, equivalent dose in body organs or tissues in rem,1 and activity of radionuclides in curies (Ci). Decimal submultiples of the units also are used. For example, equivalent dose may be given in millirem (mrem), or one thousandth (10−3) of a rem, and activity may be given in microcuries, or one millionth of a curie (μCi), or in nanocuries, or one billionth of a curie (nCi). The traditional units are used in this report because they have been used exclusively in all dose reconstructions for atomic veterans and in other documents of the dose reconstruction program and therefore are the units with which veterans are familiar. The relationships between the units used in this report and the corresponding SI units and special names are given in the table below. Quantity Previous unit SI unit Special name of SI unit Conversion Exposure roentgen (R) coulomb per kilogram (C kg−1)   1 R = 2.58 × 10−4 C kg−1 Absorbed dose rad joule per kilogram (J kg−1) gray (Gy) 1 rad = 0.01 Gy Equivalent dose rem joule per kilogram (J kg−1) sievert (Sv) 1 rem = 0.01 Sv Activity curie (Ci) disintegration per second (s−1) becquerel (Bq) 1 Ci = 3.7 × 1010 Bq 1   In dose reconstructions for atomic veterans, the biologically significant dose to body organs or tissues is called “dose equivalent.” In the present report, however, this quantity is called “equivalent dose,” as recommended by the International Commission on Radiological Protection (ICRP, 1991a).

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Preface From 1945 through 1962, the US atmospheric nuclear weapons testing program involved hundreds of thousands of military and civilian personnel, and some of them were exposed to ionizing radiation. Veterans’ groups have since been concerned that their members’ health was affected by radiation exposure associated with participation in nuclear tests and have pressured Congress for disability compensation. Several pieces of legislation have been passed to compensate both military and civilian personnel for such health effects. Veterans’ concerns about the accuracy of reconstructed doses prompted Congress to have the General Accounting Office (GAO) review the dose reconstruction program used to estimate exposure. The GAO study concluded that dose reconstruction is a valid method of estimating radiation dose and could be used as the basis of compensation. It also recommended an independent review of the dose reconstruction program. The result of that recommendation was a congressional mandate that the Defense Threat Reduction Agency (DTRA), a part of the Department of Defense, ask the National Research Council to conduct an independent review of the dose reconstruction program. In response to that request, the National Research Council established the Committee to Review the Dose Reconstruction Program of the Defense Threat Reduction Agency in the Board on Radiation Effects Research (BRER). The committee randomly selected sample records of doses that had been reconstructed by DTRA and carefully evaluated them. The committee’s report describes its findings and provides responses to many of the questions that have been raised by the veterans.

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Throughout the study, the committee’s work was greatly aided by the efforts of D. Michael Schaeffer of DTRA, the DTRA contractor team, Bradley Flohr and Neil Otchin of the Department of Veterans Affairs, and Department staff; we thank them for providing valuable historical insights for the committee’s study and providing feedback and materials for additional review. The committee and the BRER staff are grateful for the information provided by invited speakers who generously contributed their time and participated in the committee’s information-gathering meetings: D. Michael Schaeffer, Steve Powell, W. Jeffrey Klemm, Julie Fisher, Cindy Bascetta, Neil Otchin, Bradley Flohr, Pat Broudy, Richard Conant, Andy Nelson, Barry Pass, and Alex Romanyukha. The committee thanks Tony E. Carter and Sandy Ford for redacting case files. The committee is especially grateful for the assistance provided by “atomic veterans” throughout the course of its work. Veterans provided records, explained their concerns, and assisted us in understanding the conditions surrounding the nuclear-weapon tests. The committee and the BRER staff are appreciative of the information, feedback, and background materials for review provided by Gilbert Acciardo, James Avans, James Bradley, Robert Brenner, Frank Bushey, Thomas Caffarello, Boley Caldwell III, Sarah Comley, Joseph Ceonzo, Fred Clapp, Fred Clark, daughterrad (e-mail), William Duffy, Theodore Dvorak, Frank Fancieullo, William Fish, Walter Furbee, Richard Gilson, Glen Howard, Thomas Hughes, Jennifer Jones, Martin Kinney, Harold Kolb, David Lloyd, John Locke, Michael Lynch, James McDonald, Jack Nelson, James Robert Peden, Howard Pettet, Howard Pierson, Bernard Reynolds, Claude Richard, Keith Schwenk, James Warren Scott, Rodney Seidler, Delinda Sterling, R. Stockwell, Gerald Stone, Richard Stoyle, Herb Stradley, strawbry (e-mail), Arthur Templin, James Tokar, Paul Tutas, Lawrence Wagner, and Sidney Wolfeld. We hope that we have responded usefully to the veterans’ questions about dose reconstruction and the claims process. We also hope that our work will help to generate changes in the dose reconstruction program that will make it more effective. Finally, the committee thanks the National Research Council staff who worked directly with us, especially Study Director Isaf Al-Nabulsi for keeping the committee focused and assisting in the writing and preparation of our report. Dr. Al-Nabulsi was well assisted in the administration of the committee’s work by Dianne Stare and Doris Taylor. John E. Till Chairman, Committee to Review the Dose Reconstruction Program of the Defense Threat Reduction Agency

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Acknowledgments This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Council’s Report Review Committee. The purposes of this review are to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their participation in the review of this report: Harry M. Cullings, Hiroshima, Japan Edward R. Epp, Weston, MA Naomi H. Harley, New York, NY Milton Levenson, Menlo Park, CA Francis X. Masse, Middleton, MA Bruce A. Napier, Richland, WA Andrew M. Sessler, Berkeley, CA Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Richard B. Setlow, Brookhaven National Laboratory (Senior Biophysicist) and Maureen M. Henderson, University of Washington (Professor Emeritus). Appointed by the National Research Council, they were

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responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the National Research Council.

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Contents     PUBLIC SUMMARY   1     EXECUTIVE SUMMARY   5 I   INTRODUCTION   15     I.A Study Rationale and Scope,   15     I.B Background and History,   16     I.C Principles and Process of Dose Reconstruction,   28     I.D Concerns of Veterans,   41 II   THE COMMITTEE’S PROCESS   44     II.A Discussion of the Committee’s Charge,   44     II.B Sampling Procedures,   46     II.C Interaction with Atomic Veterans,   47     II.D Information Gathering,   48 III   THE PROCESS OF SUBMITTING AND DECIDING CLAIMS   51     III.A Introduction,   51     III.B Claims Filed Under Nonpresumptive Regulation,   52     III.C Claims Filed Under Presumptive Regulation,   54     III.D Communications with Veterans,   56     III.E Medical Opinions and Probability of Causation,   57 IV   PROCESS OF DOSE RECONSTRUCTION IN NTPR PROGRAM   65     IV.A Exposure Scenarios,   66

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    IV.B Estimation of External Dose,   69     IV.C Estimation of Internal Dose,   86     IV.D Dose Reconstructions for Occupation Forces in Japan,   107     IV.E Methods of Estimating or Accounting for Uncertainty,   110     IV.F Estimates of Total Dose and Uncertainty for Individual Participants,   119     IV.G Documentation and Quality Assurance,   121 V   COMMITTEE’S FINDINGS RELATED TO NTPR DOSE RECONSTRUCTION PROGRAM   124     V.A Determination of Exposure Scenarios,   124     V.B External Dose Estimation,   140     V.C Evaluation of Methods of Estimating Internal Dose,   166     V.D Dose Reconstruction for Occupation Forces in Japan,   226     V.E Committee Evaluation of Method of Estimating Uncertainty in Dose and Upper Bounds,   227     V.F Summary of Committee Findings Regarding Dose and Uncertainty Estimates by NTPR Program,   229 VI   FINDINGS RELATED TO OTHER ISSUES   231     VI.A Quality Assurance and Documentation,   231     VI.B Communication with Atomic Veterans,   236     VI.C The Low-Level Internal Dose Screen,   240     VI.D Bioassay Program to Assess Internal Exposures to Plutonium,   247     VI.E Retroactive Recalculations of Doses and Re-evaluations of Prior Compensation Decisions,   248     VI.F Implications of Committee’s Findings,   251 VII   CONCLUSIONS   257     VII.A Responses to Questions in Committee’s Charge,   258     VII.B Recommendations Regarding a System for Permanent Review of the Dose Reconstruction Program,   262     VII.C Explanation to Atomic Veterans Regarding Implications of Committee’s Findings,   263 VIII   RECOMMENDATIONS   265     REFERENCES   267 APPENDIX A   Examples of Dose Reconstruction Memoranda from Sample Cases Reviewed by Committee   281

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APPENDIX B   Sampled Case Files of Dose Reconstructions Reviewed by Committee   291 APPENDIX C   Names of Invited Speakers and Interactions with Veterans   302 APPENDIX D   Responses to Committee’s Questions   305 APPENDIX E   Analysis of Potential Inhalation Doses Due to Blast-Wave Effects at Operation PLUMBBOB, Shot HOOD, and Implications for Dose Reconstructions for Atomic Veterans   335 APPENDIX F   Unit Dose Reconstruction for Task Force Warrior at Operation PLUMBBOB, Shot SMOKY   349     GLOSSARY   361     LIST OF ABBREVIATIONS   379     COMMITTEE BIOGRAPHIES   381     INDEX   385

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