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/regs/compliance/owcp/eeoicp/main.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.
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Page last updated: November 3, 2008
Page last reviewed: May 30, 2008
Content Source: National Institute for Occupational Safety and Health (NIOSH)
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