ORP/CSD 72-1
          ESTIMATES OF IONIZING RADIATION
             DOSES IN THE UNITED STATES
                       1960-2000
  ,
f
                I'.S. ENVIRONMENTAL PROTECTION AGENCY
                      Office of Radiation Programs
                    Division of Criteria and Standards

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      ESTIMATES OF IONIZING RADIATtON^<
         DOSES IN THE  UNITED STATES
                       1960-2000
                    Special Studies Group
                  Alfred W.  Klement, Jr.
                     Carl R. Miller
                      Ramon  P. Minx
                     Bernard Shleien
                      AUGUST 1972
         U.S. ENVIRONMENTAL PROTECTION AGENCY
                 Office of Radiation Programs
               Division of Criteria and Standards
                  Rockville, Maryland 20852
For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402 • Price $1.60

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                               PREFACE
     The Federal Radiation Council* was established  in 1959 to ".  ,  .
advise the President with respect  to radiation matters, directly or
indirectly affecting health,  including guidance  for  all Federal agencies
in the formulation of  radiation  standards and in the establishment and
execution of programs  of cooperation with States ,  .  ,"  During that year
a study was initiated  to provide recommendations on  radiation protection.
As a result of  these studies  guidance was issued in  1960 and 1961.
     In early 1970.the Federal Radiation Council recommended a review of
the bases for and considerations of basic radiation  guidance previously
issued.  The review was initiated  in November 1970 by the appointment of
temporary Council staff members  by the participating agencies and con-
tracting with the National Academy of Sciences and the National Council
on Radiation Protection and Measurements for various parts of the review.
Soon after, the Environmental Protection Agency  was  formed to which  the
Council's functions were transferred.  The  interagency review was contin-
ued under the auspices of this new agency in the Division of Criteria and
Standards, Office of Radiation Programs, in which the Council temporary
staff was assigned as  the Special  Studies Group,
     This report is the first of several expected to result from the review
of radiation guidance.  It is an assessment of radiation doses in the
United States from 1960 to 1970  and predictions  to the year 2000,  Its
primary purpose is to  provide other groups  with  some estimates of future
doses to the United States population and major  contributors to these
doses that may assist  in the  formulation of general  and specific radiation
protection guidance,
^Members of the Council were  the Secretaries of  Agriculture;Commerce;
 Defense;  Health, Education,  and Welfare; Interior;  and Labor; and the
 Chairman of the Atomic Energy Commission.  The  Council's functions  were
 transferred to the Environmental  Protection Agency when the Agency  was
 established in late 1970.  (42  U.S.C. 2021 (h).)

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     The report was made possible through the appointment of full-time
staff and data furnished by the participating agencies.  A number of
other Federal and State agencies provided valuable information as well.
A large number of persons in the participating and other agencies provid-
ed useful comments on the report as did a number of private organizations
and individuals.
     The participating  agencies  and  their appointees were::
     Department of Defense                    Ramon P.  Minx, LTC,  MSC,  USA
     Department of Health, Education,
        and Welfare                           Bernard Shleien, Pharm. D,
     Atomic Energy Commission                Alfred W. Klement, Jr.
     Office of Water Programs,
        Environmental Protection Agency       Carl R. Miller
     A number of studies in progress or initiated during the review will
provide additional information which will be valuable  in assessing rad-
iation doses in the future.  More sophisticated methods are being devel-
oped and several sources are receiving more detailed study than they had
prior to this review.   In particular some sources are  being studied which
did not appear to contribute significantly to overall  doses to the total
United States population, but do contribute significantly to some individ-
ual doses.  These and other studies of sources in this category would
greatly assist in making more definitive dose estimates in future reviews
of this nature.
     In addition to the acknowledgements  above,  the  authors  gratefully
acknowledge the assistance of Mr. Samuel Wieder,  Editor,  Radiological
Health Data and Reports, for his editorial advice and  assistance with  the
mechanics of preparation for publishing the report; Mrs. Yvonne Countee
and Miss Barbara Stephens for assistance with early drafts of the report;
and Mrs. Betty Cooke for preparation of the final typescript.
                                     11

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                               CONTENTS
    PREFACE

I.   INTRODUCTION
                                                              Page  No .
    A.  Purpose and Scope -----------------------------------      1
    B.  General Procedures ----------------------------- • -----      2
    C.  Population Estimates --------------------------------      4

    REFERENCES ----------------------------------------------      5

II. ENVIRONMENTAL RADIATION -- ..... - ......... - ..... ----------      7

    A.  Natural Radiation -----------------------------------      7
        1. Cosmic Radiation ---------------------------------      7
        2. Terrestrial Radioactivity ------------------------      8
           a. External Gamma Radiation ----------------------      9
           b. Internal Radiation ----------------------------     11
        3. Summary ------------------------------------------     13

    B. Global Fallout from Nuclear Tests --------------------     13
        1. External Gamma Radiation -------------------------     14
        2. Internal Radiation ---------------- - --------------     15
           a. Inhalation ------------------------------------     15
           b. Ingestion -------------------------------------     15
        3. Summary ------------------------------------------     18

    C. Peaceful Applications of Nuclear Explosives  ----------     18

    D. Nuclear Electric Power ----------------------------- --     22
       1. Nuclear Electric Power Supply Requirements  ----- ---     22
       2. Estimated Radiation Doses -------------------------     26
          a. Uranium Mines ----------------------------------     27
          b. Uranium Mills ------------ ........ --------------     27
          c. Fabrication Plants -----------------------------     28
          d. Nuclear Power Plants ---------------------------     28
          e. Fuel Reprocessing Plants ---------------------- -     30
       3. Worldwide Radioactivity ---------------------------     41
          a. Tritium ----------------------------------------     43
          b. Krypton-85 ------------ ..... - ---------- ....... --     47

    E. Government Facilities ------- -------------------------     48
       1. Nevada Test Site ----------------- ...... --------- --     50
       2. Nuclear Rocket Development Station  ----------------     51
       3. Peaceful Nuclear Explosive Tests  ------------------     52
          a. Project Gnome ----------------------------------     53
          b. Project Gasbuggy -------------------------------     53
       4. Other Atomic Energy Commission Facilities  ---------     53
       5. Other Government Facilities -----------------------     57

    F. Private Facilities -----------------------------------     58

    G. Summary ----------------------------------------------     59

    REFERENCES ---------------------------------- ......... ---     61
                                  iii

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     APPENDICES TO ENVIRONMENTAL RADIATION SECTION 	  70
                                               90
     APPENDIX II-A  Accumulated Bone Dose from   Sr vs.  Age 	  73

     APPENDIX II-B  Dose Calculational Methods for Fuel
                    Reprocessing	'--'	  77

III. MEDICAL RADIATION 	  83

     A. Dose Estimates	  83
        1. Medical and Dental Radiology 	  83
           a. Methodology and Results of United States Studies;
              Genetically Significant Dose 	  84
           b. Extrapolation of Other Doses	  86
        2. Diagnostic Use of Radiopharmaceuticals 	  90
           a. Genetically Significant Dose 	  90
           b. Extrapolations of Other Doses 	:	  90
        3. Radiation Therapy 	•	  93
           a. Radiation Treatment of Cancer 	  93
           b. Radiation Treatment of Nonmalignant Diseases 	  95
        4. Medical Occupational Exposure 	  96

     B. Projected Doses 	  96
        1. Medical and Dental Radiology 	  96
        2. Radiation Therapy 	  99
        3. Diagnostic Radiopharmaceuticals 	  99
        4. Medical Occupational Exposure	<	 100

     C. Summary 	T	 100
     REFERENCES	 107

     APPENDICES TO MEDICAL RADIATION SECTION 	 111

     APPENDIX III-A  Summary of Information Relating to  United
                     States Studies for Determination of GSD --- 113
     APPENDIX III-B  Estimated Thyroid Dose - 1964 	 118

     APPENDIX III-C  Radiopharmaceuticals 	•	121

     APPENDIX III-D  Radiation Therapy 	 125

IV.   OCCUPATIONAL RADIATION			 133

     A. Assumptions and Limitations of Data 	 135

     B. Summary of Data from Reporting Agencies 	 136
        1. Federal Agencies 	 136
           a. Army 	 136
           b. Air Force 	 137
           c. Navy	 138
           d. Atomic Energy Commission 	 139
           e. Public Health Service			139
           f. Other Federal agencies 	 139
        2. Nonfederal Activities 	 140
           a. Atomic Energy Commission Licensees  	 140
           b. Agreement State Licensees 	 142
           c. X-ray Use in the Healing Arts	 142
           d. Medical Use of Radium	 145
        3. Summary 	 145

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     C. Internal Doses Incident to Occupation 	  145
     D. Population Dose from Occupational Exposure 	  147
     E. Population Dose from Occupational Exposure,  1960-to 1970 147
     F. Population Dose from Occupational Exposure,1980 to 2000  150
     REFERENCES 		  152
  V. MISCELLANEOUS RADIATION			  155
     A. Television Receivers 	  157
     B. Consumer Products Containing Radioactive Material  	  158
     C. Air Transport	  159
     D. Summary	  160
     REFERENCES	-		  161
VI.  SUMMARY				-	-	--  163
     A. Environmental Radiation 	  165
     B. Medical Radiation	  165
     C. Occupational Radiation 	  170
     D. Miscellaneous Radiation 	  171
     E. Total Man-rem	  171

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                               TABLES
                                                              Page No,
II-l    Estimated Annual Cosmic-ray Whole-body Doses	      8
II-2    Estimated Annual External Gamma Whole-body Doses
        from Natural Terrestrial Radioactivity 	     10
II-3    Estimated Average Annual Internal Radiation Doses
        from Natural Radioactivity in the United States 	     12
II-4    Estimated Total Annual Average Whole-body Doses from
        Natural Radiation in the United States 	•	     13
II-5    Estimated Total Annual Whole-body Man-rem from
        Natural Radiation in the United States	•	     13
II-6    Estimated per Capita Organ Doses from Inhalation
        of Radioactive Fallout	     16
II-7    Estimated Dose from Ingestion of Radioactive
        Fallout		-	----		     19
II-8    Total Annual Whole-body Doses from Global Fallout --     22
II-9    Estimated Nuclear Generating Plant Sites - 1990 ----     23
11-10   Estimated Number of Operating Reactor Plant Sites
        by Year and Region	     26
11-11   Estimated External Gamma Whole-body Doses from
        Reactor Gaseous Effluents 	     31
11-12   Projected Quantity of Reprocessed Fuel 	     33
11-13   Radionuclide Content of LWR Fuel Decayed 150 Days
        and FBR Fuel Decayed 30 Days	_____	     34
11-14   Estimated Fractional Release for Radionuclides
        Present at Time of Reprocessing	•	•	     35
11-15   Air Concentration Distance Correction Factors 	     36
11-16   Estimated Annual Dose Accrued at 3,000 Meters from
        a Fuel Reprocessing Plant per 300 Metric Tons of Fuel
        Reprocessed per Year	     37
11-17   Summary of Table 11-16	     39
11-18   Average Annual Dose Accrued to the Population Within
        100 Kilometers of a Fuel Reprocessing Plant 	     40
11-19   Estimated Annual Dose Accrued to the United States
        Population from Fuel Reprocessing 	     42
11-20   Projected World Reactor Power Capacity	     45
                                                        3
11-21   Estimated Annual Whole-body Dose from Worldwide  H -     47
11-22   Estimated Annual Doses to the United Stateg.
        Population from Worldwide Distribution of   Kr 	     48
11-23   Major Atomic Energy Commission Installations 	     55
                                   vi

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11-24   Estimated Total Annual Whole-body Doses from Other
        Atomic Energy Commission Installations 	     56
11-25   Estimated Internal Doses from Other Atomic Energy
        Commission Facilities	     57
11-26   Summary of Estimates of Whole-body Environmental
        Radiation Doses to the United States Population 	     60
IIA-1   Strontium-90 Intake						     74
                            90
IIA-2   Fraction of 50-Year   Sr Bone Dose Delivered After
        Intake		     76
III-l   Estimated Abdominal Dose from Diagnostic Radiology -     88
III-2   Estimated Thyroid Doses from Diagnostic Radiology --     89
III-3   Estimated Doses from the Diagnostic Uses of
        Radiopharmaceuticals - 1966	     92
III-4   Estimated Total Man-rem to the United States
        Population from Medical Diagnostic Radiology, 1960 to
        2000		--		     99
III-5   Summary of Estimated Doses from Medical and Dental
        Radiation			    101
IIIA-1  Summary of Information Relating to United States
        Studies for Determination of GSD 	    115
IIIA-2  Summary of Information Relating to United States
        Studies for Determination of GSD	    117
IIIC-1  Patient Administration and Dose Administered - 1966 -   121
IIIC-2  Dose per Administration		-	-    123
IIID-1  Exposed Population Radiation Therapy (Malignancies)
        Age <30	-	•	-		    125
IIID-2  Treatment of Cancer (Diagnosed 1955-1964) with
        Radiation - Age <30		-	---    126
IIID-3  Estimated Gonad Dose per Treatment 	    129
IIID-4  Gonad Dose from Radiation Therapy of Malignancies
        to Less Than 30 Age Group	    130
IIID-5  Estimated GSD from Radiation Therapy (Malignant
        Diseases) --•	    132
IV-1    Summary of Army Annual Occupational Doses - 1969 to
        1970		--		    137
IV-2    Summary of Air Force Occupational Doses - 1969 to
        1970			    138
IV-3    Summary of Navy Occupational Doses - 1969 to 1970 --    139
IV-4    Summary of Atomic Energy Commission Occupational
        Doses - 1969 -			-	-    140
                                   vii

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IV-5    Summary of Reporting Atomic Energy Commission (AEG)
        Licensee and Agreement State Licensee Occupational
        Doses - 1969 	    141
IV-6    Mean Annual Doses for Reporting Atomic Energy
        Commission Licensees - 1969	:	'-    142
IV-7    Mean Annual Occupational Doses for Agreement State
        Licensees - 1970;	-		    143
IV-8    Wisconsin Dental Facility Survey - 1969 to 1970 	    143
IV-9    Summary of Illinois Whole-body Radiation Doses - 1970   144
IV-10   Total Annual Whole-body Man-rem by Reporting Group
        and Occupation - 1969 to 1970	    146
IV-11   Total Annual Occupational Whole-body Doses - 1969
        to 1970 	    148
IV-12   Percent of Employees in Annual Dose Ranges - 1969
        to 1970							    149
IV-13   Job Category Data - 1969 to 1970		--	    149
IV-14   Estimated Annual Whole-body Doses to the United
        States Population from Occupational Exposure 	    150
V-l     Total Annual Average Whole-body Doses from
        Television Receivers - 1970 to 2000	    158
V-2     Total Annual Average Whole-body Doses to the United
        States Population from Miscellaneous Sources 	    160
VI-1    Summary of Whole-body Annual Radiation Doses in the
        United States - 1960 to 2000 	    168
                                 viii

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                                FIGURES

                                                             Page No,

II-l    Respiratory Lymph Node Dose from a One-Time Exposure
        to Plutonium	     17
                                   90
II-2    Accumulated Bone Dose from   Sr for Various Ages
        (U.S. Average) 		--     20
                    90
II-3    Accumulated   Sr Bone Dose by Several Cohort
        Populations (U.S. Average) 	     21

II-4    Predicted World and United States Nuclear Electric
        Power Requirements 	     24

II-5    National Electric Power Survey Regions 	     25
II-6    Estimated World Inventory of Tritium in the
        Atmosphere and in Surface Waters 	     44
                  85
II-7    Estimated   Kr Concentrations in the Northern
        Hemisphere from Nuclear Electric Power Production --     49
VI-1    Summary of Estimated Whole-body Radiation Man-rem
        Doses in the'United States	'•	    166
VI-2    Summary of Estimated Average Whole-body Radiation
        Doses in the United States (mrem/person) 	    167
                                  ix

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INTRODUCTION

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                            I.  INTRODUCTION

     In June 1970^the Federal Radiation Council  initiated a review of
the bases for and considerations of basic radiation exposure guidance
                       2 3
issued in 1960 and 1961.'   The study was continued by the Environmental
Protection Agency following the transfer of the Council's functions to
           4
that agency.  This report contains the results of that part of the over-
all review concerned with estimates and predictions of radiation doses
to United States populations - past, present, and future.  Other parts
of the review include a study of the scientific bases for estimating
risk by a committee of the National Academy of Sciences, a review of
models for estimating radiation doses by the National Council on Radi-
ation Protection and Measurements, and a study of risk-benefit balanc-
ing.  The overall study is scheduled to be completed by January 1973.
     A.  Purpose and Scope
     The plan for study  listed as a component:  "Collection and analy-
sis of radiation exposure data relevant to the evaluation of risk and
projections of major contributors anticipated in the future."  To im-
plement this provision of the plan the Special Studies Group (Tempo-
rary Staff) was directed to (1) collect, collate, and analyze infor-
mation on radiation sources that contribute to radiation exposures of
the general public and occupational exposures and (2) estimate the dose
associated with each source or activity and total population dose.
     The overall study was concerned with radiation guidance and the
subject of other components of the study.  The review reported here was
made without regard to numerical values of current or possible future
standards or regulations.  Instead, practices believed prevalent during
the periods under review were considered in order to provide an in-
formation base on which to evaluate current guidance.

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     Except for the obvious implication that radiation dose is related
to effects, no expression or implication with regard to radiation effects
is intended.  This is a function of another component of the overall
study.
     Since estimation of radiation dose to human populations is the
objective here, no discussion of the geographic distribution of radio-
activity or radiation sources is included except where necessary to  in-
dicate procedures used for dose estimation.  Such discussions are ade-
quately included in other studies (e.g., Reference 6).  Because the
study is directed toward estimates and predictions of radiation doses
to the population of the United States, emphasis is placed on the entire
population averages.  While special groups and unusual situations are
considered and are included in the averages, no attempt is made to em-
phasize them.  Although it was intended that only "major contributors
anticipated in the future" be considered,  some consideration was given
to all sources to determine their degree of contribution.  However,
accidents and nuclear war were not considered.  Obviously, some sources
(including special cases mentioned above)  were found to warrant only
mention for completeness.  It is recognized, however, that some of these
pose serious problems in localized situations and are undergoing study
by agencies responsible.  Throughout this report the term "significant"
is used in the sense that the estimates are or are not sufficient to be
additive with regard to the accuracy of the estimates, considering the
number of significant digits deemed appropriate.  The term as used here
is not related to radiation effects or risks.
     The sources considered are categorized in sections as shown in the
Table of Contents under the following topics:  Environmental, Medical,
Occupational,  and Miscellaneous Radiation.  Because of the nature of the
various radiation sources and/or the nature of the available data,  the
sections differ in the manner of presentation.
     B.  General Procedures
     For estimates of past doses from radiation the year 1960 was select-
ed since Federal Radiation Council guidance was issued at about  that time.
For some categories other years were selected to provide a better over-

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all view of the category.  For the present, the year 1970 was selected,
and for estimates of future doses, the years 1980, 1990, and 2000 were
used.
     Radiation doses are estimated* in most cases as annual doses.  For
                                90       239
long-lived radionuclides (e.g.,   Sr and    Pu) 50-year internal doses
are usually estimated; i.e., the dose accrued over 50 years from inges-
tion or inhalation of a nuclide during 1 year.  Emphasis is placed on
whole-body doses although organ doses are estimated when appropriate.
Whole-body dose is defined as the average dose to the whole body.  Use
of the term somatic dose also refers to the average dose to the whole
body, the magnitude of which, for purposes of this report, is assumed to
be numerically equal to the average gonad dose.   In all cases estimates
are made of average doses to the population at risk (the population
directly exposed by a radiation source) and to the entire United States
population.  This permits intercomparison of data from previous studies
as well as from different radiation sources to both the population at
risk and total populations.  Doses are given in several ways suggested
by some potential users of the information reported.  The number of man-
rem as used here is the product of an average dose and the population
at risk associated with the average dose.  The use of this unit is a
convenient means of comparing doses from various  sources, as well as
averaging.  All average annual doses are computed from the total man-rem
divided by the total population for each population unit considered.
     An attempt was made to make dose estimates as accurately as possible
with the best data available.  Estimates made by  others were considered
throughout the study.  However, independent estimates were made during
the study, although, as may be expected, many were in good agreement with
estimates made by others.  In a number of cases,  no adequate similar
projections were found.  In nearly all cases, data available are only
partially adequate for calculation of accurate doses since dose esti-
mation in general is not the objective of data collection.  In these
cases, the assumptions made, the source of data,  and the methods used
are stated or referenced.  In general, the nature of the data and the
*Reference 7 was used for basic concepts and data throughout.

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lack of good tests of the methods or models for dose estimation
against measured doses are such that reasonably good estimates of
the accuracy of the dose projections are impossible.  The dose esti-
mates for the past and present are believed to be correct well with-
in a factor of two.  Estimates for the future are probably correct
within an order of magnitude.  For some estimates, the number of digits
shown is more than is warranted by the accuracy of the estimate.  The
purpose of this was to show trends which would not otherwise be seen,
or to carry out additions to other values before rounding off.
     C.  Population Estimates
     In this report, estimates of populations used for 1960 and 1970
                     Q Q
are based on censuses '   for those years.  Estimates of future popu-
lations were based on the Bureau of the Census Fertility Assumption
Series B.    For estimates of the size of populations at risk, generally
those of others as referenced are used, but in some cases estimates
were made  during the study based on the 1960 census and extrapolated
to the year 2000.   Extrapolations are based on the  same rate of increase
as that for the entire United States or at  the same rate as past years
where data on populations at risk are available.

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                               REFERENCES

 1.   Federal Radiation Council.  1970.  Radiation protection policy.
     Action paper FRC/2/10/6.   Washington.  16 pp.

 2.   Federal Radiation Council.  1960.  Background material for the
     development of radiation protection standards, staff report.  Wash-
     ington, Report No. 1.  iii. 39 pp.

 3.   Federal Radiation Council.  1961.  Ibid. Report No. 2.  iii, 19 pp.

 4.   The President.  1970.  Environmental Protection Agency, Reorganization
     Plan No. 3 of 1970, Title 3 - The President, Presidential Documents.
     Federal Register 35(194):  15623-15626.

 5.   Federal Radiation Council Staff.  1970.  Plan for conduct of the FRC
     review of its basic guidance for radiation protection.  (Draft
     concurred in by responsible member agencies.)  Washington.  5 pp.

 6.   United Nations.  1972.  Report of the United Nations Scientific Com-
     mittee on the Effects of Atomic Radiation.  New York.  (In prepara-
     tion. )

 7.   International Commission on Radiological Protection.  1960.  Recom-
     mendations of the International Commission on Radiological Protection,
     report of the Committee II on permissible dose for internal radiation
     (1959).  Publication 2.  Pergamon, New York.  viii, 233 pp.

 8.   Bureau of the Census.  1961.  U.S. Census o_f Populations:  1960,
     Vol. 1, Characteristics cxf the Population.  Part A, Number of
     Inhabitants.  Washington,  var. pp.

 9.   Bureau of the Census.  1970.  Ibid. Preliminary reports,  var. pp.

10.   Bureau of the Census.  1970.  Projections of the population of the
     United States, by age and sex (interim revisions).  1970 to 2020.
     Washington, Series I, P-25, No. 448.  50 pp.

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II.  ENVIRONMENTAL RADIATION

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                      II.  ENVIRONMENTAL RADIATION
     In this section, doses to the United States population resulting
from all sources of environmental radiation are discussed.  The sources
include naturally occurring radionuclides and man-made environmental
radioactive material resulting from nuclear explosives, the electrical
power production process, and other governmental, industrial, medical,
and research uses.  For purposes of dose calculations, it is assumed that
                                                                 3
whole-body and gonadal doses are the same.  Doses from worldwide  H and
85
  Kr are discussed in Section D.
     A.  Natural Radiation
     Man is exposed in varying degrees to sources of radiation found in
nature depending on his activities and location.  Cosmic radiation enter-
ing the earth's atmosphere and crust is one natural source of exposure.
Nuclear interactions of cosmic rays with matter produce radiations and
radionuclides to which man is exposed.  Other sources of natural radia-
tion affecting man are elements found in the earth's crust which are
composed of one or more radioisotopes.  These sources and estimates of
their impact on United States populations are discussed below.
          1.  Cosmic Radiation
     A number of reviews and data on cosmic radiation and cosmic radi-
ation doses have been published.    The data from Reference 1 were
used in the current estimates.  Cosmic-ray dose rates vary with alti-
tude and geomagnetic latitude up to about 50 .  For example, whole-body
dose rates at sea level from Alaska to Florida range from about 45 to
30 mrem/yr., and at 45° N. from sea level to 8,000 ft. altitude, the
range is about 40 to 200 mrem/yr.  Based on such relationships, estimates
of doses were made for each county or similar political unit in the
United States.  Averages for each major political unit of the United

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States, calculated from the man-rem totals of  the  smaller political  units,


are  shown  in Table II-l.  These  are similar  to estimates made  by  others
                      Q

using similar methods.   (Revisions of  Reference 7  in preparation  at  the
                                                               *

time this  report was  being finalized indicate  that the  estimates  at  the

                                          9
highest altitudes may be somewhat too  high.  However, the overall average


would not be significantly different.)



                               Table II-l


              Estimated Annual Cosmic-ray Whole-body Doses
(mrem/person)
Average Annual Average Annual
Political Unit
Al abama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
2.
Dose
40
45
60
40
40
120
40
40
35
40
30
85
45
45
50
50
45
35
50
40
40
50
55
40
45
90
75
85
45
Terrestrial
Political Unit
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Okl ahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Canal Zone
Guam
Puerto Rico
Samoa
Virgin Islands
District of Columbia
Total United States
Radioactivity
Dose
40
105,
45
45
60
50
50
50
45
40
40
70
45
45
115
50
45
50
50
50
130
30
35
30
30
30
40
45

     Terrestrial radioactive material is present  in  the environment  because


naturally radioactive isotopes are constituents of a number of elements

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in the earth's crust.  The nuclear interaction of cosmic rays with
nuclei in the atmosphere, soil, and water also produce several radio-
nuclides.  The naturally occurring radionuclides give rise to both
external and internal irradiation of man.  Reviews and listings of
literature on environmental levels of these nuclides are available.
               a.  External Gamma Radiation
                                                              40
     The significant external gamma exposures are produced by   K and thi
decay products of the uranium and thorium series.  Exposures from radon
and radon daughters vary significantly with atmospheric conditions which
affect radon concentrations at ground level as discussed below.  Also,
the condition of the surface  (soil moisture, porosity, cultivation, pave
ment, etc.) affects exposure rates.  Therefore,  in addition to variation
with geological  and geographical factors, exposure rates vary in time
and specific location.
                                                   13-16
     Based on several hundred reported measurements      with scintil-
                                              1 fi 17
lation spectrometers, estimates have been made   '   of the range and
mean of whole-body doses by population and by areas for the United
States.  Ninety  percent of all areas fall in the range of 15 to 130
mrem/yr., while  90% of the population falls in the range of 30 to 95
mrem/yr.  The estimated mean was given as 55 mrem/yr.
     In the present study, the above referenced  data were used to esti-
mate average dose rates for counties where measurements were made.
From these county measurements, an average was calculated for each
State.  These were then used to estimate the average for the United
States population.  For these estimates  it is assumed that the vari-
ability within and among the various political units is the same as
that of the reported measurements.  Where measurements were made at
different times  in the same locations, the average was used to account
for variations in time so far as the data permitted.  Based on these
assumptions and procedures, the overall United States average dose
was estimated to be 60 mrem/yr., which is near that estimated by other
procedures mentioned above.  The averages for each State are shown in
Table II-2.  Populations of political units shown by asterisks were
assumed to have the same doses as the United States average as reasonab]

-------
estimates.  A factor of unity was used in these estimates  for conversion
of open-field air-dose measurements to whole-body doses.
Estimated Annual


from Natural

Table I 1-2

External Gamma Whole-body Doses
Terrestrial Radioactivity
(mrem/person)


Average Annual Average Annual
Political Unit
Al abama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
^Assumed to be
United States
Dose
70
60*
60*
75
50
105
60
60*
60*
60*
60*
60*
65
55
60
60*
60*
40
75
55
75
i 60*
70
65
60*
60*
55
40
65
equal to the
average .
Political Unit
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Okl ahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Canal Zone
Guam
Puerto Rico
Samoa
Virgin Islands
District of Columbia
Others i
Total United States


Doses
60
70
65
75
60*
65
60
60*
55
65
70
115
70
30
40
45
55
60*
60*
55
90
60*
60*
60*
60*
60*
55
60*
60


     There have been unpublished reports of residences built on tailings
piles at some abandoned uranium mills, as well as various uses of tail-
ings, such as in construction materials.  Based on the little infor-
mation available, doses from these sources received by relatively small
populations are estimated to be insignificant in terms of overall
                                   10

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                                                                    18
averages or total man-rem.  For example, measurements have been made
at Grand Junction, Colorado, from which dose estimates can be made.
These measurements showed an average of 107 mrem/yr.  in living areas
of residences  (above outdoor doses) to a population of about 1,800,
or about 200 man-rem/yr.  A very gross estimate for all such situations
may be 10 to 20 times this value.  This could increase the average dose
for the population of Colorado by less than 0.1 mrem/yr.  Since reme-
dial measures  are being taken to prevent similar situations in the
future and to  reduce these doses, future doses are expected to be less
than current ones.
               b.  Internal Radiation
     While all of the natural radionuclides contribute to internal radi-
                                                                    3
ation doses, only a few are found to be significant.   These include  H,
14   40        226       228
  C,   K, and    Ra and    Ra and their decay products.  Within the
               3      14
United States  H and   C are relatively uniformly distributed so that
their levels in foods and water do not vary appreciably with geograph-
                                         40
ical location.  This is largely true for   K because of agricultural
practice   (fertilizing, cultivation methods, etc.).   Radium and    Po
are similarly  affected to some extent.  These facts and the practice in
the United States of widespread manufacturing and transportation of
foods and people have an "averaging" effect on radionuclide contents of
diets throughout all geographical areas.  For example, the concentrations
   226
of    Ra in dietary samples vary as much or more at individual locations
than overall location averages differ from an average for the United
      10 17 19
States. '  '     Because of this, it appears reasonable to assess internal
radiation doses from dietary sources in the United States as a whole
rather than attempt an assessment by geographical or political unit.
     Radon is  the only significant natural radionuclide leading to wide-
spread exposure through inhalation.  It is released from soil, rock,
and building materials and contained in natural gas and other fossil
fuels.  Radon concentrations vary considerably with atmospheric and
soil conditions as mentioned above.  Continuous monitoring records
show that in many locations over extended periods of  time air con-
centrations vary both diurnally and seasonally.  '     Rainstorm and
                                    11

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                          21
wind effects are also seen.   Further variations in concentrations


would  be expected with regard to radon resulting from burning of  nat-


ural gas and other fossil fuels.  Radon in natural gas would  increase


ambient concentrations in dwellings, as well as the general environ-


ment,  depending on type of construction and ventilation of dwellings

                              22
and perhaps some other factors.   While some studies are  in progress


in this regard, insufficient data are available at this time  to pro-


vide a basis for a reasonable estimate of the natural gas contribution


to population doses.  Other fossil fuels would contribute additional


radon  to the general environment, and would be included in outdoor


measurements.  The estimated whole-body dose from dissolved radon in


the body is 3 mrem/yr.  Estimates for lung doses from inhaled radon


have ranged from about 100 to 900 mrem/yr.


     The estimated average internal dose rates to the population  of the


United States are summarized in Table II-3.  These estimates  are  quite


similar to those reported by others.' '



                              Table I1-3


          Estimated Average Annual Internal Radiation Doses
from Natural Radioactivity in the United States

Annual Doses (mrem/person)
Radionuclide*
3
H
14
C
40
K
87
Rb
210
Po
222
Rn
226,.,
Ra
228
Ra
TOTAL
Whole-body

0.004

1 .0

17

0.6

3.0

3.0

-

—
25
Endosteal Cells (Bone)

0.004

1.6

8

0.4

21

3.0

6.1

7
47
Bone Marrow

0.004

1.6

15

0.6

3.0

3.0

0.3

0.3
24
*0ther natural radionuclides would contribute to doses but ouch a small

 fraction that they would not affect the totals within the accuracy of

 these estimates.   As an example,  doses from 3H are shown here.
                                   12

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          3.  Summary
     The overall estimates of doses from natural radiation are sum-
marized in Tables  II-4 and II-5.
                               Table  II-4
 Estimated Total Annual Average Whole-body Doses from Natural Radiation
                          in the United States
                             (mrem/person)
        Source	Annual Doses
        Cosmic rays                                     45
        Terrestrial radiation
           External                                     60
            Internal	25	
        TOTAL                                          130
                               Table  II-5
    Estimated Total Annual Whole-body Man-rem from Natural Radiation
                          in the United States

Year
1960
1970
1980
1990
2000
Population
(millions)
183
205
237
277
321
Annual Man-rem
(millions)
23.8
26.6
30.8
36.0
41.7
     B.  Global Fallout  from Nuclear  Tests
     Fallout  from nuclear weapons  tests  is  another  source of environ-
mental radioactive material.  Large-scale,  high-yield  atmospheric  test
series in the past  (e.g., United States  and Soviet  tests, 1961  to  1962)
introduced radioactive material into  the  stratosphere  which was later
deposited worldwide.  The last such  test  series  was conducted  in 1962.   A
portion of the small amount of material  remaining in the stratosphere
continues to  be deposited annually.   During the  past several years, a few
atmospheric tests by the French and Chinese have been  conducted which
have been sufficient to maintain a relatively constant annual  fallout
          23
deposition.   Past and current tests  have also injected material into
                                   13

-------
the troposphere which is deposited relatively quickly within a few


degrees of the latitude of the tests.  (Local fallout from Nevada

                                                     3      85
Test Site tests is discussed in II. E; and worldwide  H and   Kr


doses are discussed in II. D.)


     Both current fallout and that deposited from past tests contribute


to internal and external population doses.  For this study, it was  as-


sumed that the rate and type of testing from 1965 to 1970 will continue


through 2000.  Estimates were made for 1963, 1965, 1969, and subse-


quent decades to 2000.  In 1963 the highest fallout deposition occurred


The year 1969 was chosen as an example of the current situation.


          1 .  External Gamma Radiation

                         137
     The accumulation of    Cs deposited from past nuclear tests is the


major source of long-lived external gamma radiation from fallout.   A


number of short-lived radionuclldes contribute significantly to doses


within a few years of their production.  Estimates of external gamma


doses from fallout in the New York City area have been made which were

                        24 25 26
verified by measurements. '  '    Those values are the basis for the


1963 estimates in this study and an extension was used to esti-


mate doses from short-lived nuclides in other years.  Estimates of

           137                                   90
doses from    Cs for 1965 and 1969 were based on   Sr deposition data

                 23
for New York City.   Two population areas were used for this purpose —

                     27 ?8                                   on
"wet" and "dry" areas. '    The average annual deposition of   Sr in

MI!                                                           2 S  *? fi
 wet  areas is estimated to be 0.74 times that for New York City.


Based on measurements in 1963, deposition in "dry" areas was estimated


to be 55% of that in "wet" areas (or 41% of that for New York City) .


The population in "dry" areas was calculated to be 15% of the United


States population.


     It is assumed that    Cs deposition is 1.6 times29 that of


  Sr, and that the factor   for conversion of    Cs deposition values


to open-field exposure rate is 1.7 x 10~3 (^H/hr.)/(mCi/mi?).  Exposure


rates (|_iR/hr.) are then converted to air dose rates (p.rad/hr.).  A

                30
shielding factor   of 0.4 due to buildings and other structures and  a

                31
screening factor   of 0.8 caused by body shielding were assumed for


conversion of open-field air doses to whole-body doses.
                                   14

-------
     Similarly, average dose estimates were made for short-lived radio-
                                           24
nuclides based on the study mentioned above.   There was no significant
contribution from these nuclides  in 1969.
     The calculated total annual  average external gamma radiation doses
to the United States population for 1963, 1965, and 1969 were 5.9, 1.8,
and 0.9 mrem/person, respectively.  Annual doses from 1970 to 2000 are
estimated to be about the same as those for 1969.
          2.  Internal Radiation
     Whole-body and individual organ doses have been estimated for in-
halation and ingestion of fallout radionuclides.
               a.   Inhalation
                                        32 33
     Radionuclide air concentration data   '   were used to determine doses
to the lungs, bone, respiratory lymph nodes, and whole body due to in-
halation.   The average air concentration from the United States data was
applied to  the country as a whole.  Dose values for individual radio-
nuclides were obtained by comparison with recommended maximum air con-
            34
centrations   or by using values  of dose to be received by the individual
per unit of activity inhaled.  '    The results are given in Table II-6.
     Most doses are received within 1 year after exposure.  However, the
            90
doses from   Sr and plutonium will be received over the 50 years follow-
ing inhalation because of their long physical and biological half-lives.
The fraction of the respiratory lymph node dose from plutonium delivered
by a certain time after a 1-year  exposure can be estimated from Figure  II-l
No attempt  has been made to determine the total accumulated dose from
the inhalation of plutonium since air concentration data are not avail-
                                                                    90
able for many years during the fallout period.  The accumulation of   Sr
doses is discussed further in the next section.
               b.   Ingestion
                               OQ    OQ    -I O-l       -I o*7
     Doses due to ingestion of   Sr,   Sr,    I, and    Cs have been esti-
                                                               37 38
mated using diet radionuclide concentration data from 12 cities. '
                                                       131
(Tritium is discussed in section D.3) Strontium-89 and    I doses are
assumed to result entirely from a milk intake of 1.2 liters/day.  (The
slightly higher-than-average milk intake will account for doses from
other food sources.)  The United States was divided into 12 regions with
                                     15

-------
Table I1-6
Estimated per Capita Organ Doses from Inhalation of Radioactive Fallout
(mrem accrued/yr . )
Lung Dosea Bone Dose
Nuclide 1963 1965 1969 1963
54MnC 0.96 0.16 b
55 c
Fe 0.02 0.01
ao <-.
Sr 0.60 0.01 0.08
qn p rl f
Sr ' 0.43 0.09 0.01 0.28
95Zr° 1.9 0.02 0.05 0.62
109CdC _ 0.01 _ __
137Cs° 0.23 0.06 0.01 0.03
1 44 c-
Ce 8.2 0.38 0.31 10.6
238Pud 0.35g 0.06 0.08 0.14f
239Pu6 4.5g 0.78 0.16 1.9f
TOTALS 17.0 1.6 0.6 14.0
a
Does not include whole-body dose .
Dose <0.01 mrem/yr. «.
From comparison with recommended MPC limits.
From dose values in Reference 35.
From dose values in Reference 36.
50-year dose for a 1-year intake (see text);
25% Sr dose given in 1st 5 years,
9% Pu dose given in 1st 5 years .
50-year dose for a 1-year intake (see text);
1965 1969


	 	


0.06 0.01
0.02
__

0.49 0.40
0.03 0.03
0.35 0.07
0.9 0,5

Whole-body Dose
1963
0.01

	
0.03
f
0.40
0.16
	
0.02
0.55
o.oif
0.19f
1.4

1965


	 	


0.09

_,_

0.02

0.04
0.2

Respiratory
Nucl ide

o o o j
238Pud

239^ e
Pu

TOTALS
Node Dose
1963
79f

i,ooof

1,080
1965
14

175

190
1969


	


0.01

: 	

0.02

0.01
0.04

Lymph

1969
19

36

55

-------
(9£ aoua-isjan tnoaj
 oq. avtnsodxg
                                !a.insodxg

                              raojj asoa apo>i
                                                       • SA
                                                               "I-II
TJ
Q)
    100
     80
Q)
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o
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6O
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0
o
l_
Q)
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     20
      0
       0
               10          20           30

                        Years After Exposure
                                            40
50

-------
delivered in 1 year except the   Sr doses which are delivered over the
one designated city considered representative of each region.  Using

                                         35
values of dose per unit activity ingested,  an average dose for the

                                        14
United States was obtained.  Doses from   C were estimated using a


percent of   C above natural levels in the body of 30% for 1963, 70%

                          39
for 1965, and 60% for 1969   with the natural dose levels as given in


Table II-3.  The results are given in Table I1-7.  All the doses are


delivered in 1 year except th<


50 years following ingestion.

                                          90
     Because of the long delivery time of   Sr doses, Figure II-2 has


been prepared so that the accumulated dose to a cohort population of a


certain age in any given year can be determined.  The method and values


used in constructing this figure are presented in Appendix II-A.  The

                                                   90
shapes of the curves are affected by the amount of   Sr intake and its


long-term retention in bone.  The average accumulated dose to an indi-


vidual in the cohort population can be read from the chart by using the


year in which the given age is attained and the graph for that age.  For


example, in 1970 the average 20-year-old person would have accumulated

                                   90
a  bone dose of about 260 mrem from   Sr.  Repeating this at 10-year


intervals gives the average individual accumulated dose as a function of


age.  Figure II-3 shows this for several cohort populations.  These


values represent a United States average and any one individual's actual


dose may vary by more than a factor of two because of variation in fall-


out and in diet.


          3.  Summary
                                     3
     The aggregate doses (except for  H) are summarized in Table II-8.


     C.  Peaceful Applications of Nuclear Explosives


     A number of possible uses of nuclear explosives have been suggested


for industrial applications.  These include excavation, gas stimulation,


recovery of oil from oil shale,  mineral recovery, underground storage,


waste and water management, and use of geothermal energy. ~    Experi-


mental programs in these areas have progressed to some extent.  This is


especially true with regard to excavation and gas stimulation which lack


relatively little additional experimentation for complete development of


capabilities and proven economic advantage.  However, development has not
                                    18

-------
                                           Table I1-7
                      Estimated Dose from Ingestion of Radioactive  Fallout
(mrem accrued/yr ./person) *
Year
1963
1965
1969
1980
1990
2000
*The
bone
14c
Whole-body
0.3
0.7
0.6
0.6
0.6
0.6
90
,..Sr doses are
Yearly yuSr

Bone
0.5
1.1
1.0
1.0
1.0
1.0
137
Cs
Whole-body
4.3
2.3
0.4
0.4
0.4
0.4
delivered over 50 years
whole-body
dose rates
89
Sr
Bone
1.3
0.2
0.2
0.2
0.2
0.2
9°Sr I
Whole-body
7.3
7.2
3.2
3.2
3.2
3.2
The whole-body dose = 0,
estimated
from Figure I 1-3
Bone
73
72
32
32
32
32
. 1 times
for the
Thyroid
25
4
3
3
3
3
the dose to
years conside
are:
       1963 =0.9 mrem/yr.
       1965 =1.9 mrem/yr.
       1969 =2.1 mrem/yr.
1980 =2.5 mrem/yr.
1990 =2.7 mrem/yr.
2000 =3.0 mrem/yr.

-------
  1600
  1400
  1200
(S)
i_
0)
Q_
0) 1000
i—

£


(f)
0
Q  800
0)
c
o
CD


"5  6°°


3

E
D

   400
   200
           Whole-Body Dose-.1/10 Bone Dose
                                                       Age 60.
                                                 Age 50
             196O     1970     198O    199O    2OOO     2010

              Year in Which Given Age is Attained
                                          90
       Figure II-2.  Accumulated Bone Dose from  Sr for Various Ages

       (U.S. Average).
                               20

-------
'S'Q) suoiq.-B-[ndO(j
                                            A"q esoQ auog jg
                                                       06
                                                                    '£-11
   1200
s-~\

 O
 0)
 i_
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 Q. 1000
 \
 E
 0)
£
0)
 0
Q
 Q)
 C
 O
CO
 I!
 E
 D
 o
 O
    800
    600
    400
    200
      o
      1955
                Whole - Body Dose -. //10 Bone Dose
             1960   1965   1970   1975   198O   1985  1990

                                      Year
                                             1995   2000

-------
                              Table I1-8

Year
1963
1965
1969
1980
1990
2000
Total Annual Whole-body

U.S.
Population
(millions)
190
194
204
237
277
321
Doses from Global

Per Capita
Dose
(mrem)
13
6.9
4.0
4.4
4.6
4.9
Fallout*

Man-rem for
U.S. Population
(millions)
2.4!
1.3
0.82
1.1
1.3
1.6
   *Internal whole-body dose rate values for   Sr are taken from the
    footnote of Table II-7.  Tritium is excluded here and is considered
    in II.D.3.
advanced to the stage where reasonably accurate estimates of the radio-
logical impact of future usage can be made.  Also, in general, appli-
cations of nuclear explosives would not be amenable to routine assess-
ment and would require assessment on an individual project basis.  Be-
cause of this and the absence of experience as a basis, no attempt was
made to assess these potential sources of environmental radioactivity.
They should be included in future reviews and projections as sufficient
information becomes available.
     Experimental activities in this area are included in II. E below,
since they are mostly Government activities with joint industrial
participation in gas stimulation experiments.
     D.  Nuclear Electric Power
     The nuclear electric power industry has grown rapidly during the
last decade and is expected to grow considerably by the year 2000.  The
various facilities involved in the production of nuclear power are
potential sources of environmental radioactivity.  These facilities will
be discussed along with estimates of radiation doses.  Also included
                             3      85
is a discussion of worldwide  H and   Kr accumulation from all sources.
          1.  Nuclear Electric Power Supply Requirements
     Estimates have been made of worldwide nuclear electric power re-
quirements.  These were used as a basis for estimates of worldwide radi-

                                    22

-------
ation doses from the nuclear power industry.  A special government study
                                                      43
was made for the United States requirements up to 1990.   That study
was used as a basis for the current study and projected to 2000 at the
same rate as before 1990 based on recent estimates of power require-
     44
ments.   These are summarized below.
     The world nuclear generating capacity was predicted to increase
                                             45
from about 20 to 2,000 billion watts electric    (OWE) between 1970 and
2000 (see Figure II-4).  The generation of this power will give rise to
radioactive effluents which will be spread worldwide.  These must be
considered in addition to  local radiation doses  in the vicinity of nuclear
power plants.
     The projections for the United States were made for each of the six
National Power Survey Regions  (see Figure II-5).  These provide a basis
for projecting results from past and current experience on a realistic
basis.  These projections  are shown in Table II-9 and Figure II-4.  The
predictions  indicated that no plants in the future would have generating
capacities under 500 million watts electric  (MWE) and the largest would
approach 10  GWE.   It should be noted that plants generally will be mul-
tiple-reactor units rather than a single reactor.
     As of December 31, 1970, there were 20 operable power reactors; 51
under construction and 36  planned  (reactors ordered), all of which would
                               Table II-9
                                                          43
           Estimated Nuclear Generating Plant Sites  - 1990






1 Nuclear Plants by Capacity (megawatts electric)
Region*
Northeast
Southeast
East Central
South Central
West Central
West
TOTAL
500-1000
7
10
1
3
3
4
28
1000-2000
19
22
10
9
6
7
73
2000-4000
17
21
8
9
9
9
73
>4000
2
7
2
1
1
13
26
Total
45
60
21
22
19
33
200
    *See  Figure  I1-5.
                                     23

-------
                              pne
                                        PUB
                                                     pap.o-cps.id
     3000
C
0)

E
Q)
i_
'5
cr
0)
o:

0)
 o
_Q)

UJ

T3
 
-------
to
01
                                                                   WEST CENTRAL
                     :	; FEDERAL POWER COMMISSION

                     .."'":  POWER SUPPLY AREA

                         REGIONS SELECTED FOR UPDATING

                          THE NATIONAL POWER SURVEY
                                     Fig-are II-5.   National  Electric  Power Survey RegionsT
                                                                                                      43

-------
                       40
begin operation by 1979.   These would have a total capacity of about
95 OWE and would be located at 72 plant sites.  The reactors planned
to be in operation in 1975 were assumed to meet power requirements up
to that time.  Additional reactors were projected for these sites or
additional sites in increments from 1980 to 1990 to meet predictions
shown in Table II-9 for the current study.  These are summarized  in
Table 11-10.
                              Table 11-10
Estimated
Number of
Operating
Reactor
Plant
Sites by
Year
and Region

Year
1960
1965
1970*
1975
1980
1985
1990

NE
1
3
9(8)
20
24
33
45

SE
0
0
KD
13
16
38
60

EC
0
2
3(3)
8
9
15
21
Region
SC
0
0
0
1
3
13
22

we
1
1
5(4)
13
13
18
19

W
0
1
3(3)
8
15
24
33

Total
2
5
21(19)
63
73
141
200 ,
   *In parentheses are numbers of sites actually in or beginning operation;
   delays prevented operation of other plants.
     Estimates of requirements for uranium oxide indicate that uranium,
mining and milling would increase by a factor of about 25 between 1970
        46 47
and 2000. '    In 1960 there were 703 operating underground uranium mines
                      48
and 166 open pit mines.   The numbers decreased in 1961 to 497 and 122.,
respectively.  In 1966, there were 533 and 88.  By 1972 there will be
                             40
21 uranium mills in operation.   In 1970 there were 10 fuel fabrication
facilities.  These facilities or additional ones are expected to increase
production by a factor of about 15 by the year 2000.  bne commercial
fuel reprocessing plant began operation in 1966.  Two additional plants
are planned to begin operation in 1971 and 1974, respectively?0  There
                                                       47
are expected to be about 15 plants in operation by 2000.
          2.   Estimated Radiation Doses
     Estimated radiation doses for the various types of facilities, in-
volved in the production of nuclear power are discussed below.
                                    26

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               a.  Uranium Mines
     It does not appear that uranium mining activities result in sig-
nificant increases in environmental radioactivity outside the immediate
vicinity of mines.  Measurements in mining communities and areas are
                                             14 15
in the same general range as non-mining areas. '    While mining activ-
ities undoubtedly increase surface uranium and its decay products, espe-
cially radon, they are not widespread and are accounted for in general
natural radioactivity measurements and estimates  (see II. A above).
Therefore, no additional population dose estimates were made for this
activity except for occupational doses.
               b.  Uranium Mills
     In the processing of uranium ore to extract uranium, the byproducts
or tailings and waste constitute a source of radioactivity in the en-
vironment.  The general practice is to pile tailings in the vicinity of
                                                                   226
the mill.  The radioactive materials of significance are primarily    Ra,
                                    222
and its decay products, principally    Rn.  Except for the possible
             222
transport of    Rn, it would be expected that, in general, no signif-
icant radioactive material would reach populated areas.  Studies have
been made at active and inactive mill sites with covered and uncovered
        49
tailings.   These studies'indicated that there was no significant radi-
ation exposure to the public from these sources.  Except for stations
directly over the tailings piles, radon concentrations and external gamma
radiation exposures were at normal background (see II.A above).
     Population doses attributable to the uranium milling industry are
expected to be relatively low.  The location of mills in very remote and
sparsely populated areas and liquid waste treatment programs, as well as
the discharge of liquid wastes to receiving waters that are not usually
used for recreation or public water supplies, would support this expec-
tation.
     Instances have been reported of contamination of streams near mills
                                           50
through seepage from solution storage ponds   and discharge of effluents
into streams. '    In the former, dissolved radioactivity was found to
be at background concentrations 1.5 mi. downstream from the mill and
the water was not used for substantial distances farther downstream.  In
                                   27

-------
the second instance,  the study resulted in a change of procedures by


1960 which reduced the discharge.  These examples are typical of such


situations .


     While uranium milling activities contribute to the content of


radioactive  material  in the environment, it appears from available


measurements that population doses from this source cannot be distin-


guished from background.  Therefore,  no additional doses were included


for uranium milling except for occupational doses.


               c .  Fabrication Plants


     For economic as  well as safety reasons, fuel fabrication plants


are designed in such a manner that reactor fuel is conserved to a very


high degree.  It is unlikely that this activity would increase levels


of exposure in the general environment.  Similar activities at govern-


ment facilities discussed below contribute no significant population


doses.  Therefore, only occupational  doses are considered for fuel fabri-


cation.


               d.  Nuclear Power Plants


     As part of studies of the long-range requirements and impacts of


the nuclear power industry, computer  models were developed to assess

                                      52 53
radiation doses from reactor effluents. '    These models were tested


with measurements made at 13 operating reactor sites.  They were used


to calculate radiation doses in the current study along with the basic1


previously discussed.

                                                          O   CO    fiO
     The principal radionuclides in reactor effluents are  H,   Co,   Co,
85^   890   90C   131   131     133V   134    137^     ^ 14()
  Kr,   Sr,   Sr,    I,    Xe ,     Xe ,     Cs ,     Cs ,  and    Ba.  The


amounts released as gaseous or liquid effluents depend on the type of


reactor, and for a given type of reactor, the effluents vary widely be-
                                             Q e    "1*31
cause of the individual designs.  Except for   Kr,    Xe ,  and    Xe ,


these radionuclides give rise to environmental contamination leading to

                                       131        133
potential internal doses.  Krypton-85,    Xe ,  and    Xe emitted in


gaseous effluents are the major contributors to external gamma doses as


a result of immersion rather than surface deposition.


                    (1)  External Radiation


     The external radiation dose model was designed to predict doses with-


in several radii of a reactor site.  It provides the average dose within




                                    28

-------
each chosen radius, the total man-rem, and the average dose to the total
exposed population.
     The model involves the use of average wind data by 22.5  sectors
around the reactor and the estimated population within each sector.
Based on experience at 13 reactors, it was assumed that whole-body
external gamma doses from atmospheric effluents were 5 mrem/yr. at
site boundaries for each reactor unit.  In general, actual levels were
much less than this, so that dose estimates are quite conservative.
Doses were calculated for populations between several radii, usually
up to 50 mi., since at this distance or less, radiation doses were
found to be at levels not distinguishable from background.  Population
estimates within each sector and radius were made for at least 2
years (e.g., 1960 and 1985) and computer calculations of doses were
    52
made.   From these, estimates were made for the years considered in
this study by interpolation or extrapolation.  This was done for each
reactor site in operation or currently planned.  As additional reactor
units at a site became operable, simple multiples of the calculations
provided estimates for each site in subsequent years.
     After 1975 when currently unplanned reactors would become operable
(predictions, see Table 11-10), the calculated doses for the operable
and planned reactors were averaged by capacity and National Power Survey
Region to provide estimates up to 1990.  This,in effect, assumes that the
average dose, exposed population, and types o£ reactors in each region
will be the same as that for existing or planned reactors.  The pre-
diction for 2000 was made by extrapolating from the i960 to 1990 esti-
mates which increased in a regular manner.
     It is not expected that a significant number of liquid-metal fast-
breeder reactors will be in operation by 1990,  although there may be
by the year 2000,  Since these reactors operate with significantly lower
                                           54
effluents than current light water reactors,  the dose estimates for
1990 to 2000 may be too high.  Also, other technological improvements
in reactor subsystems would reduce doses below those estimated.  Be-
cause of the uncertainties in the availability of advanced reactor or
component designs,  no attempt was made to assess their effect on dose
estimates,

                                  29

-------
                                                                  55
     The numerical guides proposed by the Atomic Energy Commission


would require employment of radiological waste systems which would


reduce radiation doses.   However,  the assumptions used in calcula-


tions for this report are quite similar to those which would be used


based on the proposed guides,  as application of new guides will prob-


ably have little effect  on doses.


     The estimated external gamma whole-body doses are shown in Table


11-11.  Skin doses are estimated to be about 10 times the whole-body


dose  (see e below).


                    (2)   Internal Radiation


     Because of the very low levels of radionuclides in power reactor


effluents even at the boundaries of plant sites, no definitive data are


available to base estimates of internal doses.  From limited data at a


boiling water reactor,  an attempt was made to obtain order-of-magnitude

         57
estimates.   These estimates are quite conservative and maximize doses

                                                                  131
from all exposure pathways.  The highest calculated dose was from    I

                                                 131
to the thyroid from milk and drinking water.  No    .1 was detected in


milk since levels were below detection limits.  Estimates based on


calculations from stack release rates indicated that the highest expected


levels at the nearest farm would be about tenfold less than could be

                                                 131
measured during the study.  Estimated doses from    I in drinking water


were based on estimated dilution factors from a measured point to the


nearest point of consumption.   These were conservative as consideration


was not given to decay,  uptake by aquatic organisms, or adsorption.  How-


ever, using these data,  gross  conservative estimates of time-averaged


doses 360  around the reactor  site indicated that they would be orders of


magnitude lower than those in  Table 11-11.  When applied to all reactors,


the total man-rem would be too low to affect totals of average radiation


doses.


               e.   Fuel  Reprocessing Plants


     Nuclear fuel  reprocessing is another part of the nuclear electric


power generating process which is a source of environmental radio-


activity.  In this section, estimates are made of doses accrued per year


to the whole body, skin, lung,  bone, thyroid, and respiratory lymph nodes
                                    30

-------
                                           Table 11-11
Estimated External Gamma Whole-body Doses from Reactor Gaseous Effluents

Year
1960
1970
1980
1990
2000

Man-years*
at Risk
(millions)
1.9
47.6
275
367
670

Total U.S.
Population
(millions)
183
205
237
277
321

Percent of
U.S. Pop-
ulation at
Risk
1.5
22.3
100
100
100

Annual
Man-rem
16.4
430
6,080
22,780
56,000

Annual Average
Dose to Pop-
ulation at
Risk (mrem/person)
0.0085
0.0091
0.026
0.082
0.17

Annual Average
Dose to U.S.
Population
(mrem/person)
0.0001
0.002
0.026
0.082
0.17
*By 1980,  a significant population would reside within 50 miles of more than one reactor site,
 indicated by the man-years/total U.S. population.

-------
due to exposure to radioactive material in the environment resulting
from fuel reprocessing operations.  Local effects to a radius of 100 km
(62 mi.) around a plant are considered.  Dose estimates from the nation-
                3      85
wide buildup of  H and   Kr are considered in Section II.D.3.  Since
there is only one commercial fuel reprocessing plant (Nuclear Fuel
Services in New York State) in operation at the present time and since
                                                        44
its operation is not considered typical of future plants,  the dose
values are calculated estimates and are not based on measurements.
     The calculated values depend on certain assumptions made and on
values selected for various factors in the dose estimations.  There-
fore, they depend on the validity of these assumptions and selected
values.  The calculated dose values will vary by as much as factors
of 10 to 100 by changing the assumptions and selected values.  There-
fore, the methods of arriving at the dose values will be presented so
that future changes can be made as more accurate information becomes
available.
     Only exposure to radiation from radioactive material released from
the stack of a fuel reprocessing plant is considered since future plants
                                                                     44
are expected to have little radioactivity, if any, in liquid effluent.
Exposure pathways considered are external gamma exposures from the plume
and from ground surface deposition, inhalation and skin exposure from
the plume,  and exposure through ingestion after surface deposition.  All
doses at a point a given distance  from the reprocessing plant are
assumed proportional to the air concentration of radioactive material
at that point.  Therefore,  air concentrations of radionuclides are cal-
culated and from these, dose estimates are made.
                    (1)  Air Concentration
     The air concentration at a certain location depends on the amount
of fuel processed per unit time, the amount of radioactivity of the
various nuclldes in the fuel, the release rates of the various radio-
nuclides, and the dilution from the stack outlet to the location.  (Ref-
erence 44 was heavily relied upon to supply many of the factors needed.)
     Two types of fuel are considered in the calculations - light water
reactor (LWR) fuel and fast breeder reactor (FBR) fuel.  Light water
                                   32

-------
reactor fuel consists of uranium or plutonium while FBR fuel contains
only plutonium.  For this study the LWR-Pu fuel has been added with
the FBR fuel since the amount of radioactivity produced per equal burn-
up is about the same.  Table 11-12 gives a projection of the amount of
each type of fuel to be processed up to the year 2000.
                                Table  11-12


Projected


Quantity
(metric

of Reprocessed
tons/yr .)
Reactor Fuel
Lightwater
Year
1970
1980
1990
2000
Total
200
3,500
10,000
20,000
Ub
200
2,800
3,000
3,000
Puc
700
4,000
3,000
Fueia

Type
Fast Breeder
Puc
3,000
14,000
a
Based on:
             33,000  MWd  burnup/metric  ton,
             0.30  thermal  efficiency,
             0.85  load factor,
             MWE capacity  2  years  before  processing,  and
             fuel  mixtures from Reference 44.
     Treated as LWR fuel.
     Treated as FBR fuel.
     All  fuel is  assumed  to be irradiated to  a burnup  of  33,000  MW-
days/metric  ton with a  thermal efficiency of  0.30.   The LWR fuel is
allowed to decay  for 150  days  before  processing,  and the  FBR fuel  is
allowed to decay  only 30  days  because of the  economics involved  in plu-
               44
tonium recovery.    This difference in decay time  causes a large  differ-
ence in the  amount  of radioactivity present at fuel  reprocessing time.
Table  11-13  gives the radionuclide content of the fuel at the start of
reprocessing.
     Most of the  radioactive material will go to  waste storage but there
will always  be some fraction released depending on the element and pro-
cess involved.  In  Table  11-14 are shown the  assumed fractional  re-
                                 3      85
leases used  in this study.   All  H and   Kr is released through the
                                     33

-------
Table 11-13
Radionuclide Content of LWR Fuel Decayed




and FBR Fuel Decayed

30 Days*

Concentration

Nuclide
3
H
85
Kr
89
Sr
90
Sr
90
Y
91
Y
95Zr
95Nb
99
Mo
99m
Tc
99
Tc
103D
Ru
106Ru
103mRh
111A
Ag
115m
Cd
124
b,D
125
Sn
125
Sb
125m
Te
Tf3
T O 1
127Te
129mTe
129Te
TOO
132Te
-\ o Q
129Z
131
I
*Ref erenop
(C
In LWR

692

11,200

96,000

76,600

76,600

159,000
276,000
518,000

—

—

14
89,100
410,000
89,100

—

44
86
20
8,130
3,280
6,180
6,110
6,690
4,290
—
0.
2.
44 n a
i/metric ton)
Fuel In FBR Fuel

932

10,200

637,000

43,400

43,500

921,000
2,100,000
2,660,000

1, 810

1,730

.2 14.9
1,760,000
1,290,000
1,760,000

12,600

.3 269
.3 76.7
. 0 6,720
19,600
6,860
61,100
61 , 800
181,000
116,000
4,170
038 0.053
17 139,000
_1 A

Nuclide
132

133
Xe
134
Cs
136
Cs
137
Cs
140
UBa
14°La
141Ce
144
Ce
143
Pr
1 44
•*- " * ,_
Pr
147Nd
147
Pm
149
Pm
i ^i
Sm
- co
Eu
155Eu
16°Tb
23%
238
Pu
239
Pu
240^
Pu
241
Pu
241
Am
242
Cm
244
Cm

150 Days





Concentration
(Ci/metric
ton)
In LWR Fuel In FBR Fuel

—

—

213,000

20.8

106,000

430
495
56,700 1

770,000 1

694

770,000 1
51.0
99,400


1,150

11.5
6,370
300
17.4
2,810
330
478
115,000
200
15,000
2,490


4,300

74,400

29,000

28, 800

109,000

523,000
601,000
,480,000

,280,000

644,000

,280,000
185,000
353,000
61.5

4,690

10.5
79,400
9,460
7,220
11,200
3,530
4,260
600,000
1,570
65,500
1,240

      34

-------
            133
stack while    Xe decays considerably because of holdup in the process.
The halogen and particulate release rates are values that are assumed
can be attained with advanced technology.  The particulate release rate
depends on the off-gas flow rate and on plant size, but the values given
are used for all plants in this study.
                              Table 11-14
Estimated Fractional Release of
Present
Radionucl ides
at Time of Reprocessing*

Radionucl ides
85Kr
133Xe
Tritium
Halogens
Particulates
LWR Fuel
Reprocessing
Plant
1.0
0.1
1.0
0.001
1.2 x 10~8
FBR Fuel
Reprocessing
Plant
1.0
0.1
1.0
io~7
8.5 x 10~10
           *Adapted  from  Reference  44, p.  8-12.
                                      —7         3
     A concentration  factor of  5 x 10   ((aCi/cm )/(Ci/sec. released) was
applied at  a  distance of 3,000  m from the plant stack.  This value was
selected  after  comparison of  values given for  several Atomic Energy Com-
                    44 58
mission laboratories.  '    The  ratios of  the concentration factor at
other distances  to  that  at 3,000 m are given in Table 11-15.
     The  average annual  air concentration for  individual or groups of
radionuclides was then calculated  by using the product  of the  radio-
activity  per  metric ton  (Table  11-13), the release  fraction  (Table 11-14),
the concentration factor (5 x 10   ),  and  a time factor  assuming  1 metric
ton per day plant capacity is equivalent  to 300 metric  tons processed
per year.
                     (2)   Dose Calculations at  3,000 Meters
     Doses  at 3,000 m from a  fuel  reprocessing plant to the whole body,
skin, lung, bone, thyroid, and  respiratory lymph  nodes  were calculated
from the  air  concentrations.  Whole-body  gamma dose rates from most
                                    35

-------
radionuclides in the plume were calculated using the following equation:

                                         r c
                        D(nuclide  i)  _    i i
                          D(13?Cs)      rCsCCs
                                                       2
where C is the air radionuclide concentration in |_iCi/cm  and F is  the
gamma exposure rate constant for the radionuclides being considered.
Its units are (R-cm2)/(hr.-mCi).   (See Appendix II-B for greater detail.)
Values of F were calculated for each radionuclide using F values for  a
specific gamma ray energy59 and the number of gamma rays emitted per
decay*?0  The 13?Cs dose was taken  from a detailed calculation made for
                             {- o
the Hanford, Washington,  area.   Krypton-85 dose values were taken from
an extensive calculation   that gives a whole-body dose  (from gamma
                                                        —7       3
energy) of 7 mrem/yr. for an air concentration of 3 x 10    |iCi/cm.
Results of these calculations are  shown  in Table 11-16.
                              Table 11-15
                                                         a
            Air Concentration Distance Correction Factors
                                      Air Concentration
             Distance  (m) _ Correction Factor*3
                 1,000                       10.0
                 3,000                        1.0
                 5,000                        0.50
                10,000                        0.20
                50,000                        0.026
               100,000                        0.010
             aAdapted from References 44 and 58.
             b         Air concentration at selected  distance
              Factor = - - - • -
                           Air concentration at 3,000 m
     Whole-body gamma dose rates from radioactive material  deposited on
 the ground were determined by two methods.  For the noble gases,  calcu-
                 44               85        1*3*3                    R'S
 lations of others   were used for   Kr, and    Xe was compared to   Kr
 by the use of the F factor.  All other nuclides were  compared  to  cal-
                            ~\ T7                                  t-\ ft
culated values for     I and    Cs using  calculations  for Hanford.   The
nuclides were divided  into two groups  according  to  half-life since the
half-life affects the  maximum buildup  on the  ground.   Those  with a half-
                                    36

-------
Table 11-16
Estimated Annual Dose Accrued at 3,000 Meters from a Fuel
Reprocessing Plant per
300 Metric Tons
of Fuel Reprocessed
per Year

Exposure
Pathway
A. External gamma
from
plume passage
85
1. Kr
133
2. Xe
3. All other

nuclides
B. External gamma
from
surface deposition
i 85tr
1 . Kr
133
2. Xe
3. All other
nuclides
C. Inhalation and
skin dose
from
plume passage
1. 3H

2. 85Kr

3. 133Xe

4. 144Ce

5. 131I
6. 129I
7. 9°Sr
8. Pu

a
Body Organ




Whole body

Whole body


Whole body



Whole body

Whole body

Whole body




Whole body
Skin
Lung
Skin
Lung
Skin
Lung
Bone
Thyroid
Thyroid
c
Bone
c
Bone
Lung
Annual Dose Accrued
(mrem/person at 3,000 m)
LWR Fuel




1.2

—

-3




0.09

—

~0.04




5.0
0.2
0.9
53
-
-
0.3
0.4
0.1
0.01
0.02
0.6
0.9
FBR Fuel




1 .1

9.1

-3




0.08

0.6

~0.02




6.7
0.2
0.8
48
0.3
5.7
0.04
0.05
0.7

-------
                        Table 11-16 - continued
Exposure a
Pathway Body Organ
9. Other actinides
,241. 242,,
( Am, Cm,
Cm)
10. All others
D. Ingest ion
from
surface deposition
1. 89Sr
2. 9°Sr
3. 129I
131
4. I
137
i- •*•"-** ^i
5. Cs
c
Bone
Lung
RLN
Lung



„ c
Bone
c
Bone
Thyroid

Thyroid

Whole body
Annual Dose Accrued
(mrem/person at 3,000 m)
LWR
0
0
100
~0



0
0
11

13

0
i
Fuel
.2
.8

.2



.008
.14
.2

.0

.02
FBR Fuel
0.03
0.2
20
-0.1
i


0.004
0.006
0.002

82

0.001
  Doses to organs other than the whole body are in addition to
  whole-body doses.

  At 0.07 mm depth.
 /•>
  These doses received over 50 years following exposure
  (see Section II.B.2).  All other doses received within
  1 year of exposure.

                                         131
life less than 1 year were com'pared with    I and those with a half-life
                                       137       137
greater than 1 year were compared with    Cs.  A    Cs buildup for 1 year

was used.  Assuming that ground deposition is proportional to air con-

centration, the dose rates were calculated using the T values and the

   I and    Cs data from Hanford.  A body shielding factor   of 0.82
                                 30
and a structural shielding factor   of 0.4 were applied to correct air

dose rates to body dose rates.  The results are presented in Table 11-16,
Part B.

     Skin doses and doses caused by inhalation of radioactive material

from the plume are given in Table 11-16, Part C.  The equations used in
calculating these doses are given in Appendix II-B.

     Estimated doses from ingestion of radioniiclides due to surface de-

position were based on calculations made for the Dresden Nuclear Power


                                    38

-------
Station.   The Dresden dose values  (see Appendix II-B) were corrected
to correspond to the assumed release rates from a fuel reprocessing
plant.  Exposure pathways considered were:
     (a)  atmospheric discharge	»deposition on grass	..cattle	»
          milk	> man,
     (b)  atmospheric discharge	»deposition on leafy vegetables	»
          man, and
     (c)  atmospheric discharge	»• deposition on grass 	»• cattle
          beef	»man.
The results are presented in Table  11-16, Part D.
     A summary of Table  11-16  is given  in Table 11-17 showing annual
accrued doses to the whole body, skin,  lung, bone, thyroid, and res-
piratory lymph nodes at  3,000  m from a  plant processing 300 metric tons
of fuel per year.  Each  of the individual organ doses also contains the
whole body dose.  Dose values  at other  distances can be obtained by using
the correction factors in Table 11-15.
                               Table 11-17
                          Summary of Table 11-16
               Estimated  Annual Dose Accrued  at 3,000 Meters
from 300 'Metric Tons
of Fuel Reprocessed per
Year

Body Organ
Whole body
Skina'b
b,c
Lung
t>,c
Bone
Thyroid
b,c
Respiratory lymph nodes
mrem/person at 3,
LWR Fuel
6.3
60
9.4
7.7
31
420
000 m
FBR Fuel
18
72
20
18
100
150
     3At 0.07 mm depth.
      Includes whole-body dose.
     Q
      Respiratory lymph node dose and a  small portion of  the bone  and
      lung dose are received over the 50 years  following  exposure.  Other
      doses are received within 1 year of exposure.
                                    39

-------
               (3)   Average Population Dose
     The average annual dose accrued per person for the population around
a reprocessing plant (out to a distance of 100 km) was determined using an
                                                                    ,.  62
average value of dose calculated for a specified population distribution.
If the population density is uniform to a radius of 100 km around the
plant, the average  per capita dose for a specified dose at 3,000 m is
0.027 times the dose at 3,000 m.  If the population density increases at
a constant rate as  the distance from the plant increases,  the average
dose factor is 0.015.  The first value was chosen for this study.  Ap-
plying it to the values in Table 11-17, Table 11-18 was obtained which
gives annually accrued per capita dose within 100 km per 300 metric tons
of fuel processed per year.
                               Table 11-18
              Average Annual Dose Accrued to the Population
Within 100 Kilometers of a Fuel Reprocessing Plant
(per 300
Body Organ
Whole body
Skin
Lung
b
Bone
Thyroid
Respiratory lymph nodes
metric tons processed per yr.)
Accrued Dose
LWR Fuel
0.17
1.6
0.25
0,21
0.84
11
(mrem/person/yr . )
FBR Fuel
0.49
1.9
0,54
0.49
2.7
4.0
a
 Individual organ doses include whole-body doses.
 Respiratory lymph node and part of bone doses received
 over the 50 years following exposure.
     Total man-rem was calculated by assuming a number for the popula-
tion living within 100 km of the processing plant;  1.5 x 106 was chosen
as the population value for 1970 and a  16% increase per decade was used.
This value is reasonably representative of currently operating reactors,
and the rate of population increase is  the same as for the United States
                                    40

-------
population  (Table 11-11).  From these population values and the projected
annual quantity of reprocessed fuel in Table 11-12 the annual per capita
dose was calculated for the various body organs.  The results are given
in Table 11-19.
     The 1970 dose estimates were based on assumptions used in this
study.  However, Nuclear Fuel Services' (NFS) operations are different
than assumed operations 'of the future. '       A major difference is that
much of the waste effluent is through water media rather than entirely
through the air.  Data from around NFS are not conclusive as far as pop-
                                                                        63
ulation doses are concerned.  Calculated doses to a "typical individual"
based on these data are so close to fallout background that it cannot
be determined what portion of the dose is from fuel reprocessing.  The
most significant doses are those resulting from activities involving the
stream containing liquid effluent waste.  The ingestion of fish and game
from sport  fishing and hunting provides the largest potential exposure.
The measured and calculated air concentration factor   at 3,000 m is
about 200 times less than the value used in this study.  Therefore, air
pathway doses are expected to be much less than those given in Tables II-
16 to 11-19.  The additional doses from the water pathways will keep the
total man-rem in the range of 100 to 200, however.
                     (4)  Discussion
     It must be recognized that modification of these calculations is
possible.   Release rates will depend on the technology used at each
plant, concentration factors will vary from location to location, pop-
ulation distributions will vary, and methods of dose calculation will
change as new data are obtained.  Therefore, the values in Table 11-19
may vary by as much as a factor of 10 or more.  The values in this
section do  show, however, which radionuclides result in the greatest
dose.
          3.  Worldwide Radioactivity
     Two radionuclides are of concern on a worldwide scale.  Because
of their chemical and physical properties, many separate sources of
these radionuclides may cause a general buildup of their concentration
in the biosphere.  Tritium is distributed throughout the surface waters
                                     41

-------
                                            Table 11-19

Estimated
Annual Dose Accrued to the United
States Population
from Fuel Reprocessing





Other Body
Year
1970
1980
1990
2000
Whole-body Dose
(mrem/person)
0.0008
0.02
0.09
0.2
Man-rem
to U.S.
Population
170
5,000
25,000
65,000
Skin
0.008
0.1
0.4
0.8
Lung
0.001
0.03
0.1
0.2



Organ Doses (mrem/person)
Respiratory
Lymph
Nodes*
0.05
0.8
1.4
2.3
Bone*
0.001
0.02
0.09
0.2
Thyroid
0.001
0.1
0.5
1.1
*Dose received over 50 years following exposure.

-------
of the world and is of concern to man through any exposure pathway in-

volving water.  Krypton-85, a noble gas, is distributed throughout the

atmosphere and is a source of exposure to man, both externally and

through inhalation.  All sources of these radionuclides will be con-

sidered in this section.

               a.  Tritium

     Tritium is produced naturally by cosmic rays and artificially by

thermonuclear detonations and in nuclear electric power production.  It

contributes only to internal doses because of its low beta decay energy.
                         3
The worldwide content of  H from all sources is projected and from this

the dose is estimated.

                    (1)  Natural 3H
                            3
     The sources of natural  H are cosmic ray bombardment of oxygen and
                                                                      2
nitrogen in the upper atmosphere and direct intrusion from outer space.
                                                           3
Estimates of the worldwide inventory of naturally produced  H have been

graphically summarized.   The range of most probable values is shown in

Figure II-6 and varies from 25 to 80 MCi.

                    (2)  Nuclear Explosives

     Both the fission and fusion processes of nuclear explosives produce
3
 H.  The fission process produces 1,000 to 2,000 Ci of tritium per mega-

ton (MT) of fission energy which is negligible compared to the 6 to 10
                                         fifi fi7      o
MCi produced per megaton of fusion energy. '    The  H produced by weapon

detonations and corrected for decay through 1962 was calculated using

the 6 to 10 MCi/MT of fusion energy and the atmospheric fusion yield
                                   27
detonated over certain time periods.   Tritium from underground det-

onations is assumed to be contained near the detonation site and is of
                               3
no worldwide consequence.  The  H accumulated to 1962 was corrected for

decay to the year 2000 as shown in Figure II-6.  Figure II-6 also shows

the world inventory if 20 MCi per year or 100 MCi/yr. is added by nuclear
                                              Q          £> O
detonations.  Since 1965, less than 20 MCi of  H per year   have probably

been added by French and Chinese tests.

                    (3)  Reactors

     Tritium is produced in reactors by several methods.  The most impor-

tant of these methods are in the fission process itself and by neutron
                                   43

-------
aoBjjng UT PUB a-iaqdsout:)^
                                                     jo
                                                                               '9-II
10,000
                         	Ma_xjmu_mjptal if;  100 MCi

                                                 20_MC/_Added_per year from weapons
              Weapon Produced
                (6-10 MCi/MT)
                             Total of all ranges
            Naturally Produced
         (range of probable va
                                      Reactor Produced
                                      (0.70-0.85 load factor)
     1960     1965     197O     1975     198O     1985     199O     1995    20OO

-------
interactions with boron in reactor control rods, with boron and lith-

ium in the primary reactor coolant, and with deuterium in heavy water

(D20) reactors.  '    For this study, it was assumed that  (a) all 3R

produced by the  fission process corrected for 1 year of decay will be

lost to the environment either at the reactor site or during fuel  re-
                     3
processing, (b)  that  H produced in control rods will not be released

to the environment,  (c) that  technological changes will reduce 3H  pro-

duction in the  coolant to  a negligible level, and  (d) that 5% of the

world's production of nuclear power will be by  DO reactors.  ADO reac-
                                                               o 2
tor  is assumed  to contain  430 kg of DO coolant per MWE with a  H  concen-
                                     /j
tration of 11 Ci/kg with 2.5% being lost per year  to the environment?9


                               Table 11-20
Projected World Reactor

Year
1970
1980
1990
2000

Total World*
Reactor Power
20
250
800
2,000
(OWE)
D20
Reactors
1
12
40
100
Power Capacity

U-fueled
Reactors
19
200
240
240

Pu-fueled
Reactors
0
38
520
1,660
       *Total world power values are taken from Reference 45, as
        reasonable values when compared to the projected power
        capacity of the United States.


     Total world nuclear power capacity is projected  in Table  11-20.

Five percent is allotted to DO reactors with uranium fuel and the remain-
                             £
der is divided between uranium- and plutonium-fueled reactors in the same

ratios as used in Table 11-12.  The fuel types are separated because ura-
                         3
nium fuel produces 19 Ci  H/MWE/yr. and plutonium fuel produces 36
         fifi
Ci/MWE/yr.
                       3
     Estimated reactor  H production is shown in Figure II-6.  The range

of values is caused by varying the power load factor from 0.70 to 0.85.

The upper value can be increased by 13% in the year 2000 if the fraction

of DO reactors is doubled, or the lower value can be decreased by about
    £i
10% if the amount of uranium-fueled reactors is doubled and the pluto-
                                     45

-------
nium-fueled reactors are decreased.  The upper value of the range
                                            3
could also be increased by considering some  H being formed in the

coolant of light water reactors.   These changes would about triple

the reactor range shown on the graph.

                    (4)  Total 3H

     The maximum and minimum ranges of the three individual components
   Q
of  H inventory have been added with the results shown in Figure II-6.

This shows that if no more thermonuclear explosives are detonated above
                          3
ground, the environmental  H level in the year 2000 will be less than
                                         3
half the 1970 level.  Explosive-produced  H is predominant at the pres-

ent time and will continue to be if up to 100 MCi (equivalent to 10 to

15 MT of fusion energy) are released to the environment per year.
                 3
Reactor-produced  H will not become important on a worldwide basis

until after 1990.

                    (5)  Dose
                             3                 3
     The dose from worldwide  H depends on the  H content in food and
                                                                    3
water which will depend on the worldwide inventory.  The whole-body  H

dose rate, D, is calculated from:

                         D = 0.089X  mrem/yr.
                        3
where X  is the average  H equilibrium concentration in water and diet

(nCi/liter).  The factor 0.089 was determined using a body tissue con-

tent of 60% water, a quality factor of 1.0, and a factor of 1.4 increase

in dose due to organic labeling through chronic exposure.

     The X  can be estimated in several ways.  One is to divide the total
      3
world  H inventory by the volume of circulating surface waters.  Surface
                      44 69                           16  3
water volume estimates  '   range from 1.4 to 2.7 x 10   m  (depending

on the depth of ocean waters used) with the volume between 30° and 50° N.
                                              3
equal to 0.1 of the total volume.  Since most  H is released in the mid-

latitudes of the Northern Hemisphere, it is assumed that 50% is distrib-

uted from 30  to 50  N. and 50% in the rest of the world.  For the range
   3
of  H world inventory values in 1970, this gives a range of X  of 0.2 to
                                                             w
0.7 nCi/liter.

     The Xw can also be determined by direct measurement.  It is found

that Xw varies considerably from one location to another.  Most surface
                                    46

-------
and groundwater values in the United States vary from 0.2 to 1.5

 „. ,-. . ^  71,72
nCi/liter. '


     A third method of determining X  for dose calculations is from

                                    W                        3
diet studies.  These show that from 1967 to 1969 the average  H level

                         73
in the United States diet   was about 0.5 nCi/kg.

                                                                  3

     Therefore, 0.5 nCi/liter is considered indicative of present  H


levels in the environment and in the diet, and future levels are pre-

                                                                   3

dieted by the trend shown in Figure I1-6 using 20 MCi/yr. of added  H


from nuclear explosives tests.  The resulting doses for the United


States population are given in Table 11-21.



                              Table 11-21
Estimated Annual Whole-body Dose
3
from Worldwide H

Year
1960
1970
1980
1990
2000
b.

Dose
(mr em/per son)
0.02
0.04
0.03
0.02
0.03
Krypton-85

Man-rem for U.S.
Population
3,100
9,200
7,100
6,700
8,400

     Krypton-85  is produced  artificially by nuclear explosive detonations


and by nuclear electric power production.  Nuclear explosive production


rates are very low compared  to  reactor production.  The world inventory


from nuclear explosives is calculated to be about 3 MCi.  However,, reac-


tors are already producing greater  than 10 MCi/yr.  Therefore, only re-


actor production will be considered for the future.  Dose estimates will


be determined from air concentration values.


                     (1)  Air Concentration


     The   Kr air concentrations    in 1960, 1965, and  1970 were about  5,

                 3

10, and 15 pCi/m , respectively.  Future values  of concentration  are cal-
                                                   Q C

culated from reactor production rates assuming all   Kr  (corrected for


1 year of decay) will be released to the atmosphere.   Krypton-85  yield
                                     47

-------
                                          235
corrected for decay is 410 Ci/MWE/yr.  for    U thermal neutron fission
                       239                       44
and 380 Ci/MWE/yr. for    Pu fast neutron fission.   Using fuel mix-
                  3                                                85
tures as used for  H in Table 11-20 and a load factor of 0.85, the   Kr
concentration as shown in Figure I1-7 was obtained.  For the lower
                                    85
      it was assumed that the total   Kr is distributed uniformly in
                                 ,21
curve
the total atmosphere75 of 5.1 x 10^ g (air density is 0.0013 g/cm" at
mean sea level).   For the upper curve it was assumed that 75% of the
85Kr is distributed in the Northern Hemisphere since this is where
most of it is produced.
                    (2)  Dose
     Annual doses were calculated from air concentrations.  A concen-
                 c      o
tration of 3 x 10  pCi/m  was considered to give 7 mrem/yr. to the whole
body, 310 mrem/yr. to the skin at 0.07 mm depth, and 12 mrem/yr. to the
lungs. '    Using these values and the upper range of air concentrations
in Figure I1-7, the dose values in Table 11-22 were calculated.  (It
                               Table 11-22
          Estimated Annual Doses to the United States Population
85
from Worldwide Distribution of Kr





Dose
Whole-body
Year
1960
1970
1980
1990
2000
(mrem/person)
0.0001
0.0004
0.003
0.01
0.04
(man-rem)
20
80
700
4,000
12,000
Skin
(mrem/person)
0.005
0.02
0.1
0.6
1.6
Lung
(mrem/person)
0.0002
0.0006
0.005
0.02
0.06
should be noted that in the literature, skin dose is quite often refer-
red to as whole-body dose.)
     E.  Government Facilities
     The government facilities which are potential sources of environ-
mental radiation include many types.  Those concerned with somewhat non-
routine intermittent activities are discussed separately.  The Nevada
Test Site (northwest of Las Vegas, Nevada) is considered as a single
                                   48

-------
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                                          aqq. UT
                                                           JTJI
                                                             30
                                                                        ' l-ll
   1000-
CO
 0
 a

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 o

 "(0
 -t-J
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 Q)
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 0)
 
-------
facility although several government agencies are sponsors of some
activities;  both weapons and peaceful nuclear explosives tests are
carried out  there.  Also, the Amchitka Island tests are considered
as part of that facility.  Peaceful nuclear explosives tests conduct-
ed off the Nevada Test Site are considered separately as are activ-
ities of the Nuclear Rocket Development Station (adjacent to the Nevada
Test Site) .
          1.  Nevada Test Site
     For estimating radiation doses from activities at the Nevada Test
Site for the early part of the last decade, the period from September 15,
1961 to September 15,  1962 was selected.   (A similar period in 1969 and
1970 was considered.)   This was the period of resumption of atmospheric
nuclear explosives testing following the moratorium of 1958.  During
this period, attempts  were made to collect more useful data for asses-
sing radiation doses to the population in the vicinity of the Nevada
Test Site than had been obtained previously.  Included was a relatively
extensive personnel film badge program giving measurements of actual
external gamma radiation exposures to members of the potentially exposed
                  75
offsite population.   Also, measurements were obtained providing a basis
for estimating internal doses.  These were in addition to ground monitor-
ing and station personnel film badge data.  The estimates made were based
primarily on the latter and extended with supplemental data where necessary
Calculations were made for distances where doses appeared to be in-
distinguishable from worldwide fallout.
     Two underground nuclear tests have been conducted at the test
site on Amchitka Island, Alaska.  No radioactivity was detected off
                              72
the site following these tests.   Similar results are expected for
future tests at that site.
                                7 C fj Q
     Based on the available data,  '    arithmetic average doses were cal-
culated for  each community.  Then, estimates of average external gamma
doses were made for each of the smallest census divisions in the region
of interest.   From these, the total man-rem were calculated.  During the
period from  September  15, 1961 to September 15, 1962, the calculated
average whole-body dose was 47 mrem to the exposed population of 18,000
                                     50

-------
persons, or 860 man-rem.  Since the calculations were based on personnel
film badge measurements and the sources were primarily atmospheric
volume sources, the shielding and screening factors for conversion to
doses were assumed to be unity.
     During a similar period 1969 to 1970, there were no Nevada Test
Site activities which caused doses to the population in the vicinity
of the installation.  Future doses from this source are unpredictable.
Sufficient data are not available on possible peaceful nuclear exca-
vation tests to provide a basis for predictions and each would require
separate predictions based on specific characteristics.  Other nuclear
tests' radioactivities would be completely contained underground except
for unforeseeable conditions,
                                          n c 7 Q or>
     Using levels of radionuclides in milk,  '   '   estimates of internal
doses were made using the methods described  in  II. B.  The data were
adjusted so that the doses were contributed by  only local fallout from
the Nevada Test Site.  However, the calculated  doses here are prob-
ably overestimates, while those from worldwide  fallout are probably under-
estimates.  The region of concern generally had higher levels of world-
wide fallout than  the average  for  that  section of the nation.  Worldwide
fal]
137
                                                          131
fallout dose calculations were considered in II. B.  Only    I and
   Cs appeared  in milk  in  significant  amounts over those from worldwide
fallout in the  same region  to  contribute  to  the estimates.
                                                 137
     The calculated average whole-body  dose  from    Cs  to a population
of about 792,000 was  10 mrem during  the period considered, or 7,920 man-
rem.  The average dose  to  the  thyroid  to  the same population was esti-
mated to be 9 mrem.
     The total  estimated whole-body  dose  of  8,780 man-rem to a popula-
tion of 810,000 (an average of  11 mrem  to the population at risk) gives
0.05 mrem/person to the total  United States  population  for the period
cons idered.
          2.  Nuclear Rocket Development  Station
     From 1959  through  1969, 31 nuclear reactor rocket  engine tests were
conducted at the Nuclear Rocket Development  Station.  During each of
these tests,  data were  collected and reported for purposes of radiological
                                   51

-------
assessments (e.g., References 81 to 83).  Based on these data, calcula-

tions of external whole-body doses and organ doses were made and report-

ed?4  These were used as a basis for estimates made during this study.

For this facility, doses were calculated for the entire 10-year period.

     To date,  external gamma doses were too low to be significant for
                                                                      131
all tests.  The principle effluent radionuclides from these tests are    I
    133
and    I and concentrations were too low to give significant ex-

ternal gamma exposures during cloud passage or after deposition.

     Levels of these nuclides were detected in milk and led to thyroid

dose estimates.  The average thyroid dose to a population (1960) of about

740,000 was calculated to be about 3 mrem,  or 2,100 man-rem during the

10-year period.

     It is not possible to predict the dates of future tests of nuclear

rocket engines or possible levels of effluents.  During the period con-

sidered above, the technology program was completed.   The development

of a flight-rated rocket engine has been initiated and some tests are
                          40
required during this phase.   Adequate estimates of potential doses

to populations in the vicinity of the test  facility require individual

treatment.

          3.  Peaceful Nuclear Explosive Tests

     Peaceful  nuclear explosives tests conducted at places other than the

Nevada Test Site are discussed.  To date, the following have been con-

ducted:

      Date               Project                  Location

December 10, 1961        Gnome            near Carlsbad, New Mexico

December 10, 1967        Gasbuggy         near Farmington, New Mexico

September 10,  1969       Rulison          near Grand Valley, Colorado

All of these were underground tests.  During the Gnome test, radioactiv-

ity escaped from the cavity to the environment.   The other two were gas

stimulation tests, and no radioactivity was found off the test sites
                           QC 07
during the detonation phase. '    Radioactivity was released to the en-

vironment after gas wells were drilled into the cavities to obtain ex-

perimental data.  The gas was deliberately flared, thus releasing small

amounts of radioactivity to the atmosphere.  Because of the similarities
                                   52

-------
of the Gasbuggy and Rulison events, only the former is discusser!  (see

Reference  87).  As with  the above  facilities and  the  applications

discussed  in  C, future tests  are too  uncertain with respect  to  time,

place, and  type to permit  adequate  predictions of potential  doses.

               a.  Project Gnome

      For several  hours,  some  venting  occurred sporadically during Project
                                   o c,
Gnome  shortly after  the  detonation.    The  effluent was mostly gaseous

and deposition was only  detected about  10  mi. off the test site.

Doses  in populated areas were due to  passage of the cloud.   Calculations

of external gamma doses  were  made from instrument readings at populated

locations along the path of the cloud.  These gave a  total of 30 man-

rem for a population of  about 45,000  persons, or  an average  dose of 0.7

mrem.  Shielding  and screening  factors  for conversion of measurements to

doses  were  assumed to be unity.  Analyses  of environmental samples  indi-

cated  levels  of radionuclides about the same as or lower than those for

the general region.  Therefore, no  significant internal radiation doses

resulted from this event.

               b.  Project Gasbuggy

     During the gas production  phase  of this test, radioactivity was
                              3   T 4        S S
released from the well.  Only  H,   C,  and  Kr were  detected in the ef-
       Of:
fluent.   No  radioactivity was  detected beyond 10 mi. of the gas well

and there are no  populated sites within that distance of the well.  Cal-

culational  estimates of  doses for areas beyond 10 mi. of the well were

not significant.

          4.   Other Atomic Energy Commission Facilities

     Other  Atomic Energy Commission facilities involve a wide variety

of activities in  the Atomic Energy  Program and a  large number of con-

tractor activities.  '    Most of the  major facilities operated  by and

for the Atomic Energy Commission involve multiple-purpose activities,

although a  few are concerned  with only certain phases of nuclear materials

production or manufacturing.  Most  are concerned  with research  in one or

more areas.   The majority of  facilities are those of  research contractors

at universities, and private,  commercial, and government installations.

     Most of  the  facilities involve the use of radioactivity and con-

stitute a source of environmental radioactivity through airborne or

liquid releases of wastes.  A few emit radiation  inside the  facility


                                      53

-------
which is measurable outside the facility.  The nature of the facility

and its potential for contamination of the general environment deter-

mine the degree to which data are obtained to assess the impact of  the

facility on the environment.  Facilities such as the National labora-

tories and similar installations generally have extensive programs  of

environmental surveillance of radioactivity.   Those using only relative-

ly small quantities of tracer radionuclides in research usually have a

minimal surveillance program, often simply monitoring effluents before

release to insure compliance with regulations.

     Estimates were made for populations at risk in the vicinity of the

facilities as well as for the total United States population.  The  years

considered were those typical of the early (indicated as "i960") and

latter  (indicated as "1970") parts of the decade 1960 to 1970.  The Na-

tional Accelerator Laboratory, expected to begin operation in 1971 was

also included in the "1970" estimates.  It was assumed that the situation

in the period 1970 to 2000 would be similar to that in "1970" although

different facilities may be involved.  The facilities (not considered

elsewhere in this report) contributing to significant doses are among

those listed in Table 11-23.  Included in the list are some in operation

in 1960 but not in 1970 and some beginning operation after 1960.  In

many cases,the activities at facilities have  changed considerably either

by reduction or cessation of some activities  or beginning or increasing

others.

     A large number of reports were used as a basis for the estimates
                     on_"i Q-i
made for this section.       Only the major ones contributing signifi-

cantly to doses are listed in the references.  The distances from facil-

ities to which estimates were made were sufficient to include doses

above about 0.01 mrem/yr.  Data were extrapolated to farther distances

than reported and dose calculations were made in some cases by methods

described elsewhere in this report (see II. D).  Where reported data

probably included natural and fallout radioactivity, estimates of these

were considered by methods discussed in II. A and B.

     The estimated whole-body (internal and external) doses are shown

in Table 11-24.  In most cases, external gamma radiation doses were  based
                                   54

-------
                                 Table  11-23
                Major Atomic Energy Commission  Installations
Aircraft Nuclear Propulsion Department, Cincinnati, Ohio
Argonne National Laboratory, Argonne,  111.
Atomics International, Canoga Park, Calif.
Bettis Atomic Power Laboratory, Pittsburgh, Pa.
Brookhaven National Laboratory, Upton, N.Y.
Cambridge Electron Accelerator, Cambridge, Mass.
Connecticut Aircraft Nuclear Engine Laboratory, Middletown, Conn.
Feed Materials Production Center, Fernald, Ohio
Feed Materials Production Facility, Weldon Spring,  Mo.
Hanford Facilities, Richland, Wash
Knolls Atomic Power Laboratory, Schenectady,  N.Y.
Lawrence  Laboratories,  Berkeley and Livermore,  Calif.
Los Alamos Scientific Laboratory, Los  Alamos, New  Mex.
Mound Laboratory, Miamisburg, Ohio
National  Accelerator Laboratory,  Batavia,  111.
National  Reactor Testing Station,  Idaho Falls,  Idaho
Neutron Devices Department  (Pinellas), St. Petersburg,  Fla.
Oak Ridge Research and  Development  and Production  Facilities,  Oak  Ridge,  Tenn.
Paducah Plant, Paducah, Ky.
Portsmouth Gaseous Diffusion Plant,  Piketon,  Ohio
Princeton-Pennsylvania  Accelerator,  Princeton,  N.J.
Rocky Flats Plant, Rocky Flats,  Colo.
Sandia Laboratories, Albuquerque,  New  Mex.
Savannah  River Facilities,  Aiken,  S. C.
Stanford  Linear Accelerator Center,  Palo  Alto,  Calif.
                                      55

-------
Table 11-24
Estimated Total Annual Whole-body Doses from

Year
"1960"
"1970"
1980
1990
2000

Population
at Risk
(millions)
2.4
1.6
1.8
2.2
2.5
Other Atomic Energy

Percent of U.S.
Population
at Risk
1.3
0.8
0.8
0.8
0.8
Commission

Annual
Man -r em
2,600
2,500
2,700
3,300
3,800
Installations

Average Dose to
Population
at Risk (mrem)
1.1
1.5
1.5
1.5
1.5

Average Dose to
U.S. Population
(mrem)
0.01
0.01
0.01
0.01
0.01

-------
                                                          30
on open field measurements.  Therefore, a shielding factor   of 0.4 and
                  31
a screening factor   of 0.8 were used  in those cases.   Internal doses
to the lung, thyroid, and bone are shown in Table  11-25.

                              Table  11-25
                                  Q
          Estimated  Internal Doses   from Other Atomic Energy
Commission Facilities



Year
Lung
"1960"
"1970
Thyroid
"1960"
"1970"
Bone
"1960"
"1970"


Population at Risk
(millions)

4.9
5.5

0.26
0.1

0.26
0.1

Annual Average
Dose
(mrem)

0.6
0.6

45
1.3

4.3
4.8
        a
        Do not  include  whole-body  doses.
        Probably  includes  some  fallout  although  an  estimated  fallout
        component  was excluded  from these  estimates.
          5.  Other  Government  Facilities
      Several  other government agencies  maintain  facilities  involving  radi-
 ation and radioactivity.   Included are  the Department  of  Agriculture;  De-
 partment of Defense; Department of Health, Education,  and Welfare;  Nation-
 al  Bureau of  Standards;  Geological Survey; Environmental  Protection Agency;
 National Aeronautics and Space  Administration;  and  Veterans Administra-
 tion.   The NS Savannah  began operation  in  1965  by the  Maritime  Adminis-
 tration,  Operation  of  the ship was terminated  in 1971.   Nuclear  power
 stations operated by the Tennessee Valley  Authority,  Department of  Defense
 and Panama Canal  Company are considered in II,  D.  Nuclear testing
 activities by several government agencies  are considered  as part  of the
 Atomic Energy Commission's activity in  Paragraph 1  above,
                                    57

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     A large number of government research and medical facilities uti-
lize radionuclides and radiation sources in their activities, similar
in general to such facilities operated by the Atomic Energy Commission.
Several of these include research,  experimental, and test reactors.  In
1960 there were four of these operating at a total of about 6 MW and in
1970,there were six operating at about 2 MW.  A large number of radia-
tion sources are used for industrial-type purposes;  e.g., well-logging,
radiography, and luminescence.
     Most of these facilities discharge some radioactivity to the en-
vironment as liquid and gaseous wastes, or use radiation sources which
are potential sources of environmental radiation.  None of these dis-
charge radioactivity at levels comparable to those discussed in Section
 II.E.4 which contributed significant population doses.  Based on esti-
mates for some facilities and comparisons of these facilities with
similar types as those above  (where effluents have higher levels of radio-
activity) ,  it was concluded that these other government facilities con-
tributed no significant doses to populations in the United States in the
vicinity of these facilities,except occupational doses.  Comparisons of
occupational doses suggest similar conclusions as do negative environ-
mental monitoring data (e.g.,  References 102 and 103).
     F.  Private Facilities                                         l
     Many of the major private facilities utilizing radioactivity or
radiation sources are involved in the nuclear electric power industry
and were included in II. D above.  Some others are operated under con-
tract with Government agencies and were included in II. E above.  The
remainder of private facilities include research and medical organiza-
tions and those concerned with commercial applications similar to those
discussed above.  Others are concerned with radionuclide preparation as
sources,  tracers, Pharmaceuticals, or  radiation source' devices.
     The effluents from these facilities are generally of the order of
magnitude or less than the government facilities discussed in II. E
                                  58

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Therefore, these facilities contribute no significant doses except from

occupational exposures.

     G.  Summary

     Estimated whole-body doses from environmental radiation are summa-

rized in Table 11-26.  Total man-rem will increase because the population

will increase as shown by the man-rem per million people remaining con-

stant.  Environmental radiation caused by the nuclear electric power

production process will  increase  faster  than the population but  it is

estimated to be less  than 1% of natural  radiation by the year 2000.  En-

vironmental radiation doses to the whole body are compared to radiation

doses from other sources in Section V.

     Doses to other organs of the body are  given in several sections in

the report.  Natural  internal radiation  dose estimates  for the bone mar-

row and the lung are  given in Table  II-3; fallout radiation doses to the

lung, skin, thyroid,  bone, and respiratory  lymph nodes  in Tables II-6

and II-7; doses to the same organs from  fuel reprocessing activities in

Tables 11-16 to 11-19; lung and skin doses  from the worldwide distribution
   Q C
of   "Kr in Table 11-22;  thyroid doses  frorr  activities at the Nevada Test

Site and  the Nuclear  Rocket Development  Station; and lung, bone, and

thyroid doses around  several Atomic Energy  Commission facilities in

Table  11-25.
                                    59

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                               Table 11-26
             Summary of Estimates of Whole-body Environmental
Rad:

Source
Natural
Cosmic
External gamma
Internal
Subtotal
Fallout
External gamma
Inhalation
Ingestion
Subtotal
Other
Reactors
.ation Doses


1960

8.2
11.0
4.6
23.8

l.ia
0.27a
1.0a
2.4E

0.000016
Fuel reprocessing
Worldwide 3H 0.0031
Worldwide 85Kr 0.00002
PNE tests 0.00003b
Nevada Test Site
Other AEC
installations
Subtotal
TOTAL
Population
(millions)
/?
Man-rem/10
people
0.0088C

0.0026
0.015
24.8

183

136,000
to the United

Annual Man-rem
1970

9.2
12.3
5.1
26.6

0.18
0.008
0.63
0.82

0.00043
0.00017
0.0092
0.00008
-

0.0025
0.012
27.4

205

134,000
States

Population


(millions) for Years
1980

10.7
14.2
5.9
30.8

0.21
0.009
0.83
1.1

0.0061
0.0050
0.0071
0.0007
-

0.0027
0.022
31.9

237

135,000
1990

12.5
16,6
6.9
36.0

0.25
0.11
1.0
1.3

0.023
0.025
0.0067
0.004
_

0.0033
0.062
37.4

277

135,000
2000

14.4
19.3
8.0
41.7

0.29
0.013
1.3
1.6

0.056
0.065
0.0084
0.012
__

0.0038
0.15
43.4

321

135,000
d!963 value.   A 1960 total fallout value of 1.0 was used in the TOTAL
 o:C all environmental radiation.
b
 1962 dose; not used in totals.   PNE is peaceful nuclear explosives.

 Sept. 15,  1961 to Sept.  15,  1962 dose.  This value was used in the
 1960 totals.
                                    60

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                                      64

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                                     66

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83.  Public Health Service.  1966.  Ibid. PHOEBUS 1-A.  Report SWRHL-
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                                       67

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 95.  Monsanto Research Corp.  1971.  Ibid. 1970.  U.S. AEC report MLM-
      1784.  36 pp.

 96.  Hart, J.C.  (ed.).  1963.  Health Physics Division applied health
      physics annual report for 1962.  Oak Ridge National Laboratory, U.S.
      AEC report ORNL-3490.  iv,  76 pp.

 97.  Oak Ridge National Laboratory.  1970.  Ibid.  1969.  U.S. AEC report
      ORNL-4563.  viii,  68 pp.
 98.  Cowser, K.E.  1964.  Current practices in the release and monitoring
      of 131I at NRTS, Hanford, Savannah River, and ORNL.  Oak Ridge Na-
      tional Laboratory,  U.S. AEC report ORNL-NISC-3.  vii, 107 pp.
 99.  Dodd, A.O.  (ed.).  1964.  Health and Safety Division annual progress
      report,  1963.   Idaho Operations Office, U.S. AEC report ID-12037.
      pp. 36-40, 69-73.

100.  Atomic Energy  Commission.  1971.  Environmental statement for the
      National Accelerator Laboratory, Batavia,  Illinois.  Washington.
      ii, 21 pp.
                                      68

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101.  Copp, J..J.  1971.  Summary of environmental monitoring at Ames
      Laboratory. 1962-1969.  Radiological Health Data 12(3):  119-128.

102.  Miles, M.E., J.J. Mangeno and R.D. Burke.  1971.  Disposal of radio-
      active wastes from U.S. Naval nuclear-powered ships and their support
      facilities, 1970.  Radiological Health Data 12(5):  235-244.

103.  Bouvier, J.A.  1970.  Summary of environmental radiation levels for
      the year 1969.  WRAMC ENRADMON Plan, Environmental Radiological
      Monitoring Plan.  Walter Reed Army Medical Center.  Washington.
      Appendix H-3.

104.  Hardy, E.P., Jr. and J. Rivera.   (preps.).  1970.  Radiostrontium
      in milk and  tap water.  App. E.   In:  Fallout program quarterly
      summary report.  Health and Safety Laboratory, U.S. AEC report
      HASL-217.

105.  Bureau of  the Census.  1970.  Projections of the population of the
      United States, by age and sex  (interim revisions):  1970-2020.
      Washington,  Series  I, P-25, No. 448.  50 pp.
                                         90       89
106.  Mays, C.W. and R.D. Lloyd.  1966.    Sr and   Sr dose estimates for
      the  fetus  and infant.  Health Physics 12:  1225-1236.

107.  Butler, G.C. and A. Veld.   1967.  Evaluation of radiation exposure
      from  internal deposition of three bone-seeking radionuclides.  Health
      Physics 13:  916-918.
                                      69

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          APPENDICES



              TO



ENVIRONMENTAL RADIATION SECTION
                  71

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                              APPENDIX II-A
                                             90
                  Accumulated Bone Dose from   Sr vs. Age
                      (Determination of Figure II-2)
     The bone dose values in Figure II-2 were calculated using different
90
  Sr diet data and values of dose per \j.C± intake for different age
                       90
groups.   The intake of   Sr varies for different age groups depending
                                                                    38
primarily on the quantity of milk consumed in the diet.  Adult diets
                                                    OC
are used for people over 20 years old, teenage diets   for ages 2 to
                                            37
20, and infant diets  (half the adult intake)   for up to 2 years old.
These age groupings were selected to correspond to the available data.
                               90
     The United States average   Sr intake used for each of the three
                                                    38
age groups is given in Table IIA-1.  Adult diet data   were available
                                                       37
for 1960 to 1970 for  three cities and teenage diet data   were available
for 1963 to 1969 for  10 cities.  Chicago was in both groups and provided
a means of comparison between teenage and adult diets.  For 1954 to 1959
          90                                      104
the ratio   Sr/Ca in  milk was available for adults.    For years when no
data were available,  various ratios given at the end of the table were
used to convert from  one age group to another.  The average was deter-
mined for 1963, 1965, and 1969 for 12 regions of the United States, each
represented by one of the cities for which diet data were available.  A
national average was  then determined using the populations of the 12
regions and the data  from the 12 cities.  The 1970 fraction of the pop-
ulation in each age group    was used for all years.  The national aver-
age was approximately a factor of 1.2 times the average of New York City
and San Francisco.  This factor was used for other years.
     Each yearly dietary intake was considered taken at midyear for cal-
culational purposes.  For the year of birth, an intake of half that for
adults  (to account for fetal dose) plus half that for infants was assumed
Changes in this assumption would not change the accumulated dose signif-
icantly .
     Values of dose imparted to bone per unit of activity intake used in
the calculations were:
           -1 f\C
     Infant   :  1st  year dose:  1.24 rem/^Ci intake 1st year
                 2nd  year dose:  1.52 rem/|iCi intake 1st year + 2.02
                 rem/p.Ci intake 2nd year
                                   73

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                          Table 11A-1
                       Strontium-90 Intake
                           (pCi/yr.)
	
Year
Pre-1954
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
Post-1970
Notes :
Adult data:
Infant
Teen
(ages 0 to 2) (ages 2
0
193
560
900
900
1,520
2,200
1 , 675
1 ,434
1 , 993
4,698
4,687
3, 690
2,617
2,420
2,037
1,818
1,785
1, 785
1954-1959


1,
2,
2,
4,
6,
5,
4,
5,
17,
16,
10,
7,
6,
5,
4,
4,
4,
90
ratio Sr/Ca
to 20)
0
580
680
700
700
560
600
020
300
980
700
400
840
960
263
970
818
640
640
•-,, 104
in milk
Adult
(>age 20)


1,
1,
1,
3,
4,
3,
2,
3,
9,
9,
7,
5,
4,
4,
3,
3,
3,
(pCi/g
0
386
120
800
800
040
400
351
869
986
395
373
380
234
840
073
635
570
570
Ca) x 400 =
                       pCi/yr.  ("400" varies from 330 to 480 for
                       1960-1968).
             . „„„ ^ r „ 37                New York + San Francisco   , „
             1960-1970   U.S.  Average =	 x 1.2.
                               37
Infant data:   0.5 of adult data.

Teen data:   1963-1969 (from Reference 37)
            1954-1962, 1.5 times adult data for same years
            1970 and after, 1.3 times adult values (less because of less
                           deposition resulting in less influence of milk
                           on total intake).
                              74

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                       37 105
         Teen and adult  '   :   50-year dose  (after age 2)
                              = 9.1 rem/)j.Ci intake during
                                1st two years
                              + 8.4 rem/p.Ci intake after age 2.
The fraction of the 9.1 rem or 8.4 rem accumulated each year after  intake
is given in Table IIA-2.  Several of these values had  been calculated
based on a decline of   Sr in the body according to the equation  t  "e
                                                    90
where t is time after intake in days, n is 0.20 for    Sr, and X is  the
  Sr decay constant.    These values were plotted, a curve drawn, and
then the values of fractional accumulated dose for each year after  in-
take were taken from the curve.
     The accumulated dose at various ages was determined by summing the
dietary intakes times the accumulated dose per unit activity intake for
the number of years after intake being considered.  These dose values
are presented in Figure II-2.
                                      75

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Table IIA-2
Fraction
90
of 50-year Sr Bone
Dose Delivered
107
after Intake

Years after
Intake
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Fraction of Dose
Delivered
0.072
0.121
0.169
0.210
0.246
0.274
0.313
0.344
0.373
0.402
0.428
0.456
0.484
0.510
0.534
0.555
0.577
0.600
0.619
0.636
0.655
0.675
0.693
0.708
0.726
Years after
Intake
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Fraction of Dose
Delivered
0.741
0.757
0.770
0.783
0.798
0.810
0.821
0.834
0.846
0.857
0.867
0.878
0.888
0.898
0.909
0.919
0.929
0.937
0.946
0.956
0.965
0.975
0.985
0.993
1.000
     76

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                               APPENDIX  II-B

             Dose Calculational Methods  for Fuel Reprocessing


     1.   Whole-body Gamma Doses

     Whole-body gamma dose rate from  a single  radionuclide,  due  to  im-

mersion in a cloud of radioactivity can  be determined  from  the equation:


                               r c
                         2 TT     i i
                   D  =  —- •	rem/hr.

                         103    "i


where |j. is the linear attenuation coefficient  for  air,  C  is  the  average
                                         3
air radionuclide concentration in (j.Ci/cm , and F is  the gamma exposure
                      2
rate constant in (R-cm )/(hr.-mCi) for the radionuclide being considered.

The above equation is obtained by taking half  of an  integration  over  an
infinite sphere of radioactivity.   Assuming  \i is  constant  over  the  range

of gamma energies of  in'

by the following ratio:
                                                                   137
of gamma energies of interest, each radionuclide can be related to    Cs
                           D(nuclide i)
                                          T"1  C
                             D(   Cs)      Cs Cs



    137
The    Cs dose  rate was  taken  from a detailed calculation for  the  Hanford
                 CO
Washington, area  and multiplied by six  since the  dilution factor for


Hanford  is  six  times  lower  than the dilution factor used in this study.


     2 .  Skin Doses and  Doses  Due to Inhalation
         3  ~~~~  '                           4~
          H  Whole-body dose  rate =3.6«10X»1.4 rems/week

                                               44          3
              where X is the  air concentration   in ^Ci/cm  and


              the factor 1.4  takes into account an  increase in dose

                                                             70
              due to  organic  labelling from  chronic exposure.

                                        3            44
              Skin dose  rate  = 1.7 • 10 X rems/week.   (All organ


              doses are  in  addition to whole-body doses.)

         85                                       300X        .   59,61
          Kr  Skin dose  rate  (0.07 mm depth) =        7 mrem/yr.


                                   5X           61
              Lung dose  rate  = — - —   '7 mrem/yr.



       TOO                                    _
          Xe  Skin dose  rate  (surface) = 0.23EXAt (Reference 58)

                    —                                         133
              where E =  0.112  Mev (the average beta energy of     Xe)

                                 7
              and At  = 3.15 •  10  sec./yr.
                                     77

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          133                                                    58
             Xe  Skin dose (0.07 mm depth) = 0.20 • surface dose.


                                    2 3X
                 Lung dose rate =   t '10-y mrem/yr.


                                        85
                 from a comparison with   Kr lung doses.


          144                     3 » 10 X        34
             Ce  Bone dose rate =  ' . 10_9 mrem/yr.



                                  1.5 • 104X      .  34
                 Lung dose rate = 	-^- mrem/yr.



          129                        3 • 104X       ,  34
             I   Thyroid dose rate = —	^Q mrem/yr.



          131                        3 • 104X      ,  34
             I   Thyroid dose rate =	 mrem/yr.
                   y                 3 • 10-9



            Sr   Bone dose rate = X • 20 • 10  cm /day air intake •  365

                                    3                       35
                 days/yr. •  0.7 « 10  mrem/50 yr./|j.Ci intake.


Pu Isotopes and Other Actinides

    239
For    Pu:
                              3
     bone dose rate = 226 •  10  mrem/50 yr./|j.Ci intake,
                              3

     lung dose rate = 588 •  10  mrem/50 yr./|j.Ci intake, and


     respiratory lymph node  dose rate = 132 • 10   (mrem/50 yr.)/|_iCi  intake.

                       240                                 239
     Plutonium-238 and    Pu were considered equivalent to    Pu because

                         34                   241    241    242    244
their MPC 's are the same.   Other nuclides  (   Pu,    Am,    Cm,    Cm)

                 239
were compared to    Pu by using ratios of their MPC 's for different body


organs.   Whole-body MPC  ratios were used for bone and respiratory  lymph
                        a

node doses and lung MPC  ratios were used for lung doses.
                       3.

Other Nuclides

     "~^    15 • 10 X      .
     Lung dose rate = 	n— mrem/yr.
                         10~H
                                                       _ Q        O

since the MPC  of most radionuclides is greater than 10   u.Ci/cm.  Those
             a

with lower MPC 's were individually checked to determine their  significance.
              a
                                    78

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     3.   Doses Due to Ingestion o£ Surface Deposition

                                             57
         Dose values from Dresden calculation:
Nuclide
89Sr
9°Sr
137Cs
129
Critical
Organ
Bone
Bone
Thyroid
Whole-body
thvrniH rln .<=; p^ -
Release Rate Dose at 3,000 m
(pCi/sec.) (mrem/yr.)
7,300
5
550
123
, R.R. (129D
= fS a • 	
5
8
3
1
131T ^
• T nrtcip •
.4 •
.2 •
.4 •
.8 •
i n
io-3
io-5
io-4

                             R.R.  (I)

                                      -] o Q     -I Q I

where R.R. is the release rate of  the    I or     I, the 5 takes into

                                                                  34
account the difference in thyroid  dose for the same concentrations,


and the factor 10 (a gross estimate) takes into account the buildup of

129                                                  44
   I in the environment because of its long half-life.
                                     79

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III.  MEDICAL RADIATION

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                       III.  MEDICAL RADIATION
     In this section, doses to the United States population resulting from
radiation exposures in the healing arts are discussed under the following
headings:  Medical and Dental Radiology, Diagnostic Use of Radiopharma-
ceuticals, Radiation Therapy, and Medical Occupational Exposure.
     A.  Dose Estimates
     At present,  the use of  radiation  in the healing arts  is recognized
as the largest manmade component of radiation dose to the United States
population.  This includes medical diagnostic radiology, clinical nuclear
medicine, radiation therapy, and occupational exposure of medical and
paramedical personnel.  Drawing comparisons between radiation doses to
the population from medical  x-rays and other sources of exposure is
difficult.  First, the radiation is delivered to an individual largely
on the basis of the professional judgement of an individual practitioner.
Second, a limited portion of the body  is normally exposed during X-ray
examinations as contrasted with the whole-body exposure received from
many other sources, and this exposure  is intermittent and delivered at
high dose rates,  as opposed  to the constant low-level exposure from most
other sources.  This dissertation is presented to estimate doses accrued
to specific exposed populations and to the United States population as
a whole from the  medical uses of radiation; in addition, trends in the
use of radiation  in the healing arts and their effect on radiation dose
will be explored.  Extrapolations and projections made  in this study
concerning specific organ doses and future population doses are, in all
cases, based on presently available data and assume a continuity of para-
meters cited in the original base line information,
          1.  Medical and Dental Radiology
     The potential mutagenic effect of x radiation received from medical
exposure led early to a dosimetric designation that would adequately ex-
press genetic significance.  Genetically significant dose  (GSD) is one
index of radiation received  by the genetic pool.  This  index permits
comparisons between diverse  national surveys and serves as an important
                                    83

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measure of x-ray exposure.  Estimates of  the  components  of  this  index
have permitted  the  identification of those medical  x-ray procedures
which  contribute most  to  the genetic effect of  radiation and thus
focuses corrective  action on them.  Mathematically, the GSD  is expressed
                                   A
                                ED N P
                                  i i i
                          GSD = --
where D  = the average gonad dose to persons age i who receive
       i
           x-ray examinations,
      N  = the number of persons in the population of age i who
       i
           receive x-ray examinations,
      P  = the expected future number of children for a person
       i
           age if and
      N. = the number of persons in the population of age i.
      Ihe magnitude of x-ray dose to segments  of the United States popu-
 lation has been reported in numerous studies  (Appendix III-A).      These
 studies have been limited to estimations  of GSD or, in some cases, to
 gonad dose.   Population studies of x-ray  dose resulting from diagnostic
 radiology vary as to time of inception (beginning in 1953), scope (local
 or national), population size and characteristics,  survey methods, and
 dosimetry.  One of the objectives of this review is to estimate some
 doses of somatic significance from available published and unpublished
 information.
                a.  Methodology and Results of United States Studies;
                    Genetically Significant Dose
      Calculation of GSD for a population group is subject  to broad vari-
 ations.  National and local population studies most often  obtain the
 annual GSD by weighting the individual gonad doses received during x-ray
 examinations by the number of individuals examined and by  the relative
 *Assumes an equal fertility rate in the x-rayed population being studied
  and the total population.
                                    84

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contribution of these persons to the expected number of future children

produced by the population.  An alternative procedure is to estimate the

mean annual gonad dose to that segment of the population below the age

of 30 and consider it equivalent to the GSD.  The equivalence of

the two methods is based on the preponderance of potential child-bearing

and child-fathering individuals in the age group below 30.

     Changes in diagnostic radiographic techniques and their relative

rate of use (influenced by the year the study was conducted and the loca-

tion where it was performed) have a great effect upon the results obtained.

In addition, parameters such as the health characteristics and the fraction

of the population exposed, the accuracy of gonadal dose determination,

and the method by which x-ray machine output is measured; all these influence

the estimates made from a survey and limits comparisons between surveys.

     Estimates of United States population GSD range from 18 to 136 mrem

according to different reports.     This variation is influenced by

relative child expectancy, age and sex distribution of the subjects,

usage distribution of specific examinations, and gonad dose per examina-

tion.  While no one variable can account for the differences in the

results obtained, the incidence of obstetrical examinations and the

weight given to doses from these examinations appear to explain, to some

extent, some of the differences in the range of values reported.  For

example, examinations of pregnant women provided approximately 30% of
                                   3
the total GSD in New Orleans  (1962), while the contribution of pregnant

women in the Public Health Service 1964 study was very small.

     Published information from the Public Health Service survey of

x-ray exposure in the United States indicates a GSD of 54.6 mrem in

1964.  Preliminary information from a repeat study in 1970 yields a GSD

of 35.5 mrem.   At this time, the significance of this difference cannot

be clearly evaluated because  information as to the magnitude of the

uncertainty surrounding these results has not as yet been published.

Although the error in the representativeness of the entire population
               12
sample is small,  the representativeness of dose estimates in any specific

examination-age-sex group can significantly influence the result.  For

example, in 1964 lumbo-sacral and lumbar-spine examinations of 15- to



                                   85

-------
29-year old males accounted for 30% of the entire GSD (16.5 mrem).
Furthermore,  approximately 70%* of the difference between the 1964 and

1970 results are attributable to this examination-age-sex group.
     Testicular exposure of individuals in this examination-age-sex

group is relatively infrequent,  but because of the magnitude of the
potential testicular dose from this examination and the child expectan-

cy of this age group,  these doses have a large influence on the resultant
population GSD.  The magnitude of the testicular dose appears to depend

on whether or not the testes are in the direct x-ray beam.  Accordingly,
when the testicular doses from the PHS 1964 survey are plotted,they tend
                                13
to follow a bimodal distribution,  the lower  dose peak corresponding  to

examinations in which the testes are out of the direct beam and the upper
dose peak corresponding to examinations in which the testes are in the
direct beam.  The degree of certainty surrounding the determination of
testicular dose in this examination-age-sex group is dependent upon the
number of measurements made.  The data indicate that the number of measure-
ments in the 1964 and 1970 surveys of this examination-age-sex group were
       13
limited.   The small number of examinations in which testicular doses were
measured and the nature of the distribution introduce uncertainty into
the  available  GSD information.
               b,  Extrapolation of Other Doses
                    (1)  Abdominal Dose
     In order  to evaluate somatic implications of the radiation doses
received by the population from diagnostic x-ray usage, dose estimates

for  specific organs are needed.  Such estimates are generally not yet avail-

able for the U.S.  As a first step in estimating an approximate relative

somatic dose,  one might determine the mean dose in the center of the

abdomen.   (It  must be remembered that the true specific organ doses depend
on many parameters such as field size, type of projection,  etc.)  An  index
of the abdominal dose is provided by the PHS  studies of 1964 -  1970,  which

*[T6.5 mrem  (1964 GSD contribution from male  lumbo-sacral  lumbar-spine
 15-29-year age group) minus at least 3.2 mrem  (maximum estimate 1970
 GSD contribution from male lumbo-sacral lumbar-spine 15-29-year age
 group)]  4-  [54.6 (1964 GSD) minus 35.5  (1970  GSD)] .
                                     86

-------
produced ovarian dose estimates for each procedure completely reported
in the surveys, regardless of patient sex.  This  information has not
been previously published.  The ovarian and "simulated ovarian doses"
were computed as the mean of the estimated left and right ovarian doses
generated for each examination for which dose could be calculated in the
               14
PHS study files.  The per capita ovarian* and  simulated ovarian doses"
weighted for representation in the United States  population will, for
the sake of simplicity and to differentiate them  from the true gonad
doses=f* be referred to as the "abdominal dose."   Because the entire pop-
ulation regardless of age was employed, the data  were not weighted for
future child-bearing potential, and the dose estimates were not as
sensitive to small variations in beam size and position, the diffi-
culties encountered in determination of GSD were  reduced.  The "abdominal
dose" values are presented as an index of somatic dose in an effort
to provide an alternate  to the GSD estimates and  to establish a basis
for analyzing contributing factors and evaluating future trends.  The
biological significance  of the "abdominal dose" is not evaluated in this
report, nor have these estimates been used to develop values for other
                    i
organs.  The unequal distribution of body areas exposed, the non-homo-
geneity of human tissue, and variations of dose with age, all preclude
such application.
     The estimated abdominal doses for 1964 and 1970 (based on prelim-
inary data) are presented in table III-l.  Results are not presently
available for fluoroscopy during 1970, and these  doses have been esti-
mated from the ratio of  radiography to fluoroscopy doses in 1964.  An
estimate of the abdominal dose from dental examinations was not made,
but this would be less than 0.3 rarem annual per capita dose since no
dental film in the Public  Health  Service  survey  produced  an estimated
gonad dose higher than 0.2 mrem.  Considering  only  the exposed popula-
tion  (i.e., only persons receiving x-ray  examinations), the abdominal
*Estimates made using the  dose model yield  ovarian  and "simulated ovarian
  doses"  at a  depth of 10 cm.
**The true gonad doses being the  ovarian  dose  for females and testicular
  dose for males.
                                    87

-------
     dose for males remained the same in 1970 as it had been in 1964 while
     that for females appears to have risen.  The reason for the rise  in
     female dose needs to be elucidated.  The annual per capita abdominal
     dose to the whole United States population appears to have increased by
     about 20%,  the entire increase being due to the rise in the female dose.

                                     Table  III-l
                   Estimated Abdominal Dose from Diagnostic Radiology
                   (Simulated Ovarian Dose  - Male; Ovarian - Female)
                  Annual per Capita
                     Dose for the      Size  of
                  Exposed Population   Exposed
                         (mrem)         Population
                                              Annual per
                                          |    Capita Dose for
                                 Fraction of  tne Whole U.S.
                                 Whole U.S.   Population
Year
Male  Female  Both  (thousands)  Population
(mrem)
1964
Radiography 150 126 138 66,086 0.354
Fluoroscopy 273 318 296 7,779 0.042
Total
1970*
Radiography 148 156 153 75,400 0.377
Fluoroscopy** 269 394 328 8,600 0.043
Total

49
12
61

58
14
72
 *Preliminary  results.
**Estimate  based on  ratio  Radiography/Fluoroscopy  for 1964.

                    (2)   Thyroid Dose
          Because of their proximity to the thyroid gland,  examinations of the
     head and  neck,  chest,  and mouth are most likely to contribute to the thyroid
     dose.   Estimates of thyroid dose  (Appendix III-B) indicate that for the
     exposed population  in 1964,the per capita thyroid dose was 172 mrem from
     examinations of the head and neck.   For the population as a whole the
     annual per capita dose was about  7 mrem.  This large difference is due
     to the relatively small size of the population experiencing this type of
     examination in  1 year.  If one were to assume that the ratios of doses
     to the lens of  the  eye and to the thyroid gland for head and neck exam-
     inations  and for dental examinations are the  same,  the estimates above
                                         88

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   may be made.   Such  a  procedure  does  not  take  into account  differences
   in X-ray beam  projections  and in  beam  geometry.   With  the  same  reser-
   vations, assuming that  the ratio  of  the  skin  dose to the male gonad
   dose for abdominal  examinations has  the  same  ratio as  the  skin  dose
   to the thyroid dose for chest examinations, one  is able to estimate
   thyroid doses  of 171  mrem  from  a  photofluorographic chest  examination
   and 15 mrem from a  radiographic chest  examination.  Thus,  in 1964, the
   per capita thyroid  dose for the exposed  population from chest examina-
   tions was 69 mrem while the corresponding  dose for the whole population
   was 19 mrem.   -No estimates have been made  of  the contributions  of exam-
   inations of the abdomen and extremeties  to thyroid dose due to  virtually
   a complete lack of  information.
        During 1964, 226,700,000 dental films were  taken!2  According to the
   distribution of film  types used    and  estimates  of thyroid dose per
   film for each  film  type,  '   the  per capita thyroid dose in 1964 was 57
   and 14 mrem in the  exposed and whole populations,  respectively.  A summary
   of annual per  capita  thyroid doses from  medical  and dental  diagnostic
   radiography is presented in Table  III-2.
                                  Table  II1-2
               Estimated Thyroid Doses from Diagnostic Radiology


Annual per
Capita Dose
for the Exposed
Population
Source (mrem)


Size of
Exposed
Population
(thousands)



Fraction of
Whole U.S.
Population
Annual
per Capita
Dose for the
Whole U.S.
Population
(•nrem)
Examinations of
head and neck (1964)
Examinations of
chest and thorax (1964)
Dental examinations
(1964)
172

 69

 57
 7,500
51,100
45,900
0.04
0.27
0.25
                           19
                           14
                                        89

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          2.  Diagnostic Use of Radiopharmaceuticals
     Other sources of radiation doses in the healing arts, more  recent
in terms of use than x-ray machines, are radiopharmaceuticals.   These

materials find use in the diagnosis, and in a few specific cases  in  the
treatment of disease.  Because of their newness, exposed populations are

still limited in size.  However, there is strong evidence of the  in-

creased use of these radiation sources.
               a.  Genetically Significant Dose
     An early estimate (1956) of genetically significant dose from the
medical uses of radionuclides indicated a dose of 8 mrem per person per
    18                                                   131      32
year.   This analysis was based on the total quantity of    I and   P

shipped during the year,  including both diagnostic and therapeutic uses,

and did not include age selection and procreative potential.  A  sub-
                       19
sequent analysis (1957),   assuming a diagnostic examination rate of

150,000 to 200,000 per year, of which probably not more than 25,000 exam-
inations were performed per year on patients below age 3'0, indicated that
the total accumulated patient gonad dose accrued from the diagnostic use
   131
of    I would be 375 rem (sum of doses to all'exposed individuals) to '
this younger age group.  The genetically significant dose would be
equivalent to 0.004 mrem, assuming that  50% of the noninstitutional  '
civilian population was below age 30.  An equal gehetic'ally significant
dose was alleged to be accrued through other diagnostic radionuclide pro-
cedures for a total annual GSD of 0.008 mrem.
                                   20
     More recent information (1966)   on radiopharmaceutical usage patterns
provided a basis for evaluating an estimated total accumulated gonad dose
of 195,000 rem (sum of doses to all exposed individuals) from all diag-
nostic radiopharmaceutical procedures to all age groups.  Again, if one

assumes that 12.5% of the individuals receiving these 'procedures are
below age 30,  and that 50% of the total  population is also below age 30,
then the 1966 estimated annual GSD is 0.26 mrem from the diagnostic use'
of radiopharmaceuticals.

               b.  Extrapolations of Other Doses

     Calculation of radiation doses to specific organs from radiophar-
maceuticals requires a knowledge of three parameters:  (a) radiopha'r-
                                    90

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maceutical usage rates,  (b) activity per patient  administration,  and
(c) the dose delivered to a specific organ per unit  activity  adminis-
                                                  90
tered.  During a 1966 Public Health Service  study7   questions were  asked
of 7,204 physicians licensed to  use radionuclides in medical  practice.
The reported number of patient administrations of various  pharmaceuti-
cals in specific procedures was  based  on the response of 54%  of  those
queried.   In some cases, this study also documented  the average  activity
administered per procedure for a 70 kg-male.  For those procedures  where
these latter data were missing,  the  recommended  activity  administered per
                                           21
procedure was obtained from  a  current  text    and/or  the manufacturer's
literature.  The organ specific  doses  per  unit activity administered
                                                                     22
represent the median  values  from a  range of values recently  published.
However, the authors  acknowledge that  reliable biological  data necessary
for absorbed-dose calculations is unavailable for many nuclear medicine
procedures.  Thus, only limited information on all of the  required para-
meters  is available.  Based  on this  information, the cumulative  radiation
dose  to a specific  organ  from  a  specific radionuclide was  calculated
 (Appendix III-C).   The estimated annual ptr capita doses  for the exposed
population  and  for  the whole United States population from the diagnostic
use of  radiopharmaceuticals  in 1966  are presented  in Table III-3.
      The most significant dose was  that accrued  to the thyroid from admin-
istration of     I.  Most  of  this dose  was  due to the performance of    I
thyroid function  tests and scans.  If  the  recommended dose* had  been admin-
istered, the estimated thyroid dose  per procedure would have been 5 to  15
rem  (depending  on dose administered and thyroid  size) for a function test
                                     21
and 50  to 150 rem for a  thyroid  scan.   Based on meager reports  on  actual
                                           131
practice in 1966, the average  activity of     I administered per  thyroid
function test was reported to  be 27  u.Ci and  the  average activity admin-
                                    20
istered per thyroid scan  was 46  (iCi.   Unfortunately, the data on the
average activity  administered  are from a very limited number of  responses
 (  30).   In  the  case of thyroid function tests,  the  data on the average
activity administered from the Public  Health  Service survey exceeded the
                                           21
quantities  recommended in current practice.    Using  the reported data,
*5-10|iCi for uptake and  50-100|aCi for  scan.

                                     91

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                                 Table III-3
Estimated Doses from the Diagnostic
Uses of Radiopharmaceuticals - 1966






Specific Organ Dose
Thyroid
131
I thyroid function
/131
\ I thyroid function
131
I thyroid scanning
131
I other
99m
Tc brain scans
125
I thyroid scans
Other radionucl ides
TOTAL

Gonads
131
I thyroid function
131
I thyroid scanning
131
I other
203
Hg
Other radionuclides
TOTAL
Whole body
131
I thyroid function
131
I thyroid scanning
131
I other
Other radionuclides
TOTAL

Annual
per Capita Dose
for the Exposed
Population
(mrem)

3
5 to 15 x 10
47 x 103
3
78 x 10
3
1.6 x 10
3
2.4 x 10
3
67 x 10
-




69

114

86

630
134



55

91

44
279



Size of
Exposed
Population
(thousands)


481
481

252

320

104

2
339




481

252

320

89
356



481

252

320
445




Fraction of
Whole U.S.
Population


0.0025
0.0025

0.0013

0.0017

0.0005
-5
10
0.0018




0,0025

0.0013

0.0017

0.0004
0.0019



0.0025

0.0013

0.0017
0.0023

Annual
per Capita
Dose for the
Whole U.S.
Population
(mrem)


37*
117J**

101

2.7

1.2

0.7
-
143*
(220)**


0.17

0.15

0.15

0.25
0.25
1.0


0.14

0.12

0.07
0.64
1.0
**Based on small survey sample.
                                       92

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the estimated annual per capita thyroid dose to the whole population was


220 mrem.  If the recommended dose for thyroid function tests was admin-


istered, the annual per capita whole population thyroid dose would have


been 143 mrem.  Despite the relatively small size of the exposed popula-


tion, administration of radiopharmaceuticals for thyroid tests contributes


the major radiation dose to the thyroid gland.  It is  interesting to note

                      125
that the dose from an    I thyroid scan is only moderately lower than


that of an    I scan.  The dosimetric advantages of    I over    I are


partially negated because more is administered per procedure.  The radio-


pharmaceutical    Tc, available from   ™Tc-  Mo generators, has been

                              131
found a useful substitute for    I in certain scanning procedures.  The

                                                  131
thyroid dose from this nuclide is low relative to    I.

                131
     Other than    I, radiopharmaceuticals which deliver relatively high

                                                               203
doses to an individual experiencing a diagnostic procedure are    Hg and

198
   Au.  The annual per capita dose to the whole body when considered for


the population as a whole, is approximately 1 mrem.


          3.  Radiation Therapy


     The treatment of cancer with radiation is an established medical


modality, the object of which is the delivery of large quantities of radi-


ation to the diseased tissue.  With this purpose in mind, and because radi-


ation exposure is not considered an undesirable side effect in therapy


procedures as it is in diagnostic radiography, it appears judicious to


estimate population dose from radiation used in treating cancer only in


terms of the genetically significant dose for the whole United States pop-


ulation.  In the use of radiation in nonmalignant diseases, where other


modalities of treatment may be available and the use of radiation may be


more open to question, population dose could be calculated both in terms


of GSD  and specific organ doses.  Unfortunately, information relative to


the use of radiation for the treatment of nonmalignant disease is sparse.


               a.  Radiation Treatment of Cancer


     In order to obtain an estimate of the population  GSD from radiotherapy


of cancer, several informational items are required:
                                     93

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                    (1)  the number of individuals less than 30 years of

age having a particular  malignant disease first diagnosed in any one year,
                    (2)  the proportion of the above individuals receiving

radiation therapy,
                    (3)  the proportion of individuals receiving radiation

therapy and surviving,
                    (4)  the gonad dose per treatment, and
                    (5)  the reduction in fertility due to the disease

itself*
     Information on and  estimates of these parameters, albeit in differ-
ent time periods,  are presented in Appendix III-D.  Using the incidence
                                23
of cancer in Connecticut in 1966,  the occurrence, by age distribution

and by type and site of  the malignancy,  can be approximated for the entire
                                                    24
United States.  Unpublished data were made available   that provided in-

formation on the proportion of persons treated with radiation and the

5-year survival rates in the under-30 age group for the years 1955 through

1964.  It is estimated that malignant diseases occurred in 93,000 indi-

viduals under the age of 30 in the United States during 1966, and that

approximately 25,000 were treated with radiation (X' ray,  teletherapy, and

brachytherapy not differentiated).

     Having established  occurrence, treatment, and survival rates, esti-

mates of gonad dose and  appropriate fertility rates are required.  No

comprehensive United States information on this subject appears to exist
                         25
and British data for 1957   seem to provide the best approximation of

United States practice,   in some cases,  the data used for gonad doses are
maximum estimates,  since for treatment of cancers of unspecified sites

(lymphomas, leukemia, endocrine tissue,  and melanomas), doses found

during treatment of the  lower abdomen, pelvis, and upper thigh were em-

ployed.  In these cases, a correspondingly lower fertility rate was also
used in the calculations.

     Assuming that the gonad dose to the population under age 30 is a

measure of the population GSD and that the size of this population is

*For example, females receiving radiation therapy to the pelvic region
 were assumed to have no future childbearing potential.  For the reduced
 fertility factors employed see Appendix III-D, Table III-D-5.

                                    94

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50% of the total noninstitutional civilian population, then the esti-
mated annual GSD from radiation therapy of malignant disease is approx-
imately 5 mrem.
     No estimate of the GSD from use of radiopharmaceuticals and radium
in the treatment of malignant diseases is made since there is little
likelihood that the number of persons under age 30 treated in such a
                     19
manner would be large.
               b.  Radiation Treatment of Nonmalignant Diseases
     Radiation therapy has been used for the treatment of nonmalignant
conditions of the skin such as acne and eczema, inflammatory processes
such as bursitis and spondylitis, and other conditions.  There is no
significant information concerning the usage and doses accrued to the
United States population from this application of radiation.
     Unpublished information from the 1964 study (which was not published
because its relative standard sampling error was 25%) indicated that approx-
imately 597,000 persons received 3,445,000 radiation therapy procedures
in 1964, of which 1,700,000 procedures were directed to the skin of the
head.  It is estimated that 525,000 procedures  (relative standard error
of approximately 50%) were to the skin of the head to the age group
below  30 years.   Based on the age  of the population  involved  and  the
fact that approximately 70% of these procedures were administered by
dermatologists, it is likely that the majority of these procedures were
for nonmalignant skin conditions.  These same data indicate that the
approximate average number of exposures per patient  is four.  Given the
large sampling error,one might estimate that the population at risk under
age 30 experiencing radiation therapy to the head was 131,500.
     If a commonly suggested technique is employed (75 R per treatment to
each side of the face, 50 to 100 kVp), then the estimated gonad dose  is
1.5 mrem. '    The annual per capita GSD from dermatological therapy  to
the head is thus relatively low and is estimated to  be 0.008 mrem.  In-
formation on doses to other organs, specifically for the lens of the  eye
and thyroid gland, is not available.  Although the contribution of these
types of examinations to the gonad dose and GSD is minimal, it should be
mentioned that somatic doses to a sizable group of individuals may be high.

                                    95

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     For the most part,  administration of radiopharmaceuticals for therapy
of nonmalignant illnesses in the under-30 age group is limited to the
treatment of hyperthyroidism.    This procedure accounted for 61.4 percent
                                                              20
of radiopharmaceutical therapy procedures for all ages in 1966.
     The estimates of the extent of use of radiation in the United States
for treatment of nonmalignant  conditions are based on tenuous data.  Un-
fortunately, suitable data are not available.  Neither is information
available on specific organ doses.  From studies in other countries prior
to 1962, it was reported that GSD's were as high as 4.5 rem from the use
                                     28
of radiation in nonmalignant diseases,
          4.  Medical Occupational Exposure
     Estimation of dose accrued to the population because of occupational
associations with the delivery of medical radiation is constrained, in that
only film badge data are available and various agencies and facilities
define an occupationally exposed individual differently.  Unpublished data
on occupational radiation exposure from medical sources present informa-
                               29
tion gathered in several States.   Film badge data serve as the only
available index of whole-body  dose.
     An independent analysis of this information, presented in detail else-
where in this report, indicates the following mean annual doses:  medical
x-ray workers 320 mrem,  dental  x-ray workers 125 mrem, radioisotope work-
ers 262 mrem, and radium workers 540 mrem.
     A population at risk of 195,000 and 171,000 persons in 1968 has been
reported for the medical and dental occupational exposure groups, respec-
      30
tively.   Counting radium and radioisotope workers, the total exposed
population is estimated to be  approximately 454,000 persons so that the
annual per capita dose to the United States population as a whole is
0.56 mrem (see IV below).
     B.  Projected Doses
          1.  Medical and Dental Radiology
     Projections of doses from diagnostic medical radiography must take
into consideration a variety of variables,  These include changes in the
rate of delivery of radiographic examinations, in the age and sex distri-
bution of the patients,  in the distribution of examinations by type, and
                                    96

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in the dose per examination.  In the case of GSD, the projected fertility

rate per age group also may influence the resultant estimate.  Further-

more, future doses will be influenced by technical, educational, and

regulatory actions which could modify patient doje.  These variables

are difficult to evaluate, and projections of radiation dose from medical

radiation must be evaluated with consideration for the uncertainties
involved.

     Film sales provided an early estimate of increased usage of radio-

logical services.  Between 1945 and 1965,film sales increased at the rate
                 31
of 5.4% per annum.   More recent preliminary evidence indicates that film
                                                 32
usage has increased at the rate of 4.7% per annum.   Information relative

to changes in patient usage rates is probably more pertinent to changes

in radiation dose than are increases in film sales or use.  A study in

selected hospitals indicates  that between 1963 and 1968 the annual rate

of discharges of patients in  any diagnostic radiation category and in

total diagnostic radiation categories increased  by 3.6 and 6.6%, respec-
      33
tively.   Preliminary information from the 1970  Public Health Service

study yields a somewhat lower indicator of the rate of delivery of radio-

graphic medical examinations.  Based on the 1964 and 1970 studies, the

examination rate for medical  diagnostic radiography increased from 61.8

examinations per 100 persons  in 1964 to 68.5 examinations per 100 persons
                                    32
in 1970 or a 1.6% increase per annum.   Thus, the  information presented

above leads to an estimate of between 1 and 4% increase per annum in the

rate of delivery of radiographic procedures.  At least some of this in-

crease appears to be due to the expansion of radiology services to persons

who previously did not have such care available  (i.e., persons with low
                                           32
family income and in the age  group over 65).

     Other available information relevant to projected dose pertains to

potential reduction in patient dose due to improved collimation and

technique.  Experience in a large teaching hospital showed that about

30% of radiation dose delivered pursuant to x-ray  examinations could
                                       (2
be reduced by optimization of technique.  This is  inclusive of 10%

unnecessary radiation due to  repetitive examinations.  In particular,

optimization of technique could reduce the amount  of radiation dose


                                   97

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delivered in a gastrointestinal tract examination by 20% and in other


abdominal examinations by 27%.  The effect of collimation in dose re-


duction is dependent upon the procedure,  position, and film size.  Re-


ductions in bone marrow dose due to collimation appear to vary from 17


to 80%; while for gonad dose, exclusion of the gonadal regions from the

                                           34
direct beam can reduce the dose by a factor   of 5.  Gonadal shielding


is particularly important in reduction of male gonad doses, and, report-


edly, reduces this dose by about 92% for a shield acceptable to most

        35
patients.   An optimistic evaluation of the reduction of genetically


significant dose by collimation indicates that a large reduction is


possible through simple restriction of beam size to film size.  In


practice, this is not accomplished easily  or carried out routinely,


since it requires care in positioning the patient and x-ray tube, as


well as selection of proper cone or x-ray field size adjustment.  From


the above discussion it appears reasonable that as much as a 50% re-


duction in dose might be possible due to technical and educational meth-


ods .


     In fact, there is some evidence that technical improvements are


occurring.  While a survey of x -ray facilities between 1963 and 1968


indicated that at least 28% of medical x -ray machines were improperly


collimated.   A comparison of the 1964 and 1970 Public Health Service


studies shows that collimation improved in all types of x-ray facilities

                  32
during this period.


     The information presented in this report comparing the estimates


of GSD and annual per capita abdominal dose for 1964 and 1970 is such


that no firm conclusions can be drawn at this time as to changes.  In


view of the possible decrease in the GSD and increase in the abdominal


dose estimates shown by the Public Health Service 1964 and 1970 studies,


and the fact that the magnitude of the uncertainty surrounding these


figures has not, as yet, been determined,  no firm conclusion can be drawn


at this time as to future radiation doses.  _Lf one assumes that there is


no change with time in the mean abdominal dose to the whole population,


i.e., if technical improvements keep pace with increased usage, then the


man-rem received by the population depends only upon population size.
                                    93

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Using an annual per capita abdominal dose of 72 mrem would yield the


projected man-rem listed in Table III-4.






                               Table III-4


         Estimated Total Man-rem to the United States Population
from Medical Diagnostic Radiology - 1960 to 2000

Year
1960
1970
1980
1990
2000
Population
(millions)
183
205
237
277
321
Estimated Total
Man-rem
(millions)
13.2
14.8
17.1
19.9
23.1
     Dental x-ray visit rates during 1961 and 1964 are similar, with a


slight decrease during the latter year being attributable to sampling


differences.'    Between 1964 and 1970,  a gradual rise of about 4% per


year in the rate of dental x-ray visits is evident.  Using a per capita


dental x-ray visit rate of 0.27 and an average of five films per visit,


the predicted whole-body man-rem to the United States population from


dental x-rays in the year 2000 is less than 200,000.


          2.  Radiation Therapy


     The purposeful delivery of radiation in the case of radiation therapy


is an argument against the inclusion of this source of radiation in esti-


mates of accumulated man-rem doses to  the population.  There is no sig-


nificant information to indicate the direction that the doses  from radi-


ation therapy will take in the future  even  though  its use might increase.


          3.  Diagnostic Radiopharmaceuticals


     Studies of radiopharmaceuticals indicate  increases in the rate of

                                                                31 37
administrations of between 15 and 20%  per year in the mid-1960's.


More recent information based on sales of radiopharmaceuticals indicates

                                  38
an annual increase of 25% per year.    It appears judicious to  estimate


that in the 1960's the use of radiopharmaceuticals  increased fivefold
                                   99

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during the 10-year period and that an increase of sevenfold may be ex-
perienced in the next 10 years.   Thereafter,it is difficult to make pre-
dictions, especially in terms of dose since technical changes are likely
to play a large role in dose reduction in a rapidly changing field.
Assuming no technical changes, and the growth pattern indicated above,
it is expected that the whole-body man-rem to the United States popu-
lation in 1980 from diagnostic use of radiopharmaceuticals will be 3.3
million man-rem.  Even with a slowing of the rate of increased use of
radiopharmaceuticals the accrued whole-body man-rem could easily reach
approximately 15% of the total dose from medical uses by the year 2000.
     Improvements in equipment have led to decreased dosage require-
ments in thyroid function tests  and kidney scans, and the substitution
of radionuclides yielding lower  patient exposure have already reduced
total body and kidney doses per  procedure.  Even with these improvements,
in the 4-year period, 1964 to 1968, one institution reports that the aver-
age whole-body dose per patient  increased from 100 mrem to 160 mrem due
                                            37
to the increased use of radiopharmaceuticals.
          4.  Medical Occupational Exposure
     Projections of future occupational dose are based on the growth ex-
pectation for medical and dental personnel.  This projection assumes that
the manpower requirements for the radiological sciences are growing at
                                              31
the composite compounded rate of 7.1% per year.   For dental personnel
projected doses are based on approximately 0.87 dental workers per 1,000
population and it is assumed that this ratio (which has remained fairly
                       39
constant) will continue.   Using the dose estimates previously presented,
the projected accrued annual whole-body man-rem dose to the United States
population by the year 2000 is less than 0.2 million man-rem.
     C.  Summary
     A summary of estimated doses from medical and dental radiation is
presented in Table III-5.
     The genetically significant dose provides one index of the magnitude
of radiation dose to the population from the use of radiation in the heal-
ing arts.  The main contributor to the GSD in 1964, reported to be 55
mrem, was diagnostic medical radiography.  The genetically significant
                                   100

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                                                   Table III-5
o
Summary of Estimated Doses
from Medical and Dental Radiation

Dose Category
or Organ
Genetically
significant dose^
(1964)
(1970)
(1966)
(1966)
"Abdominal dose"
(1964)
(1970)
Whole-body
dose (1966)
Source

Medical and dental
diagnostic radiography
Same
Radiation therapy
Radiopharmaceuticals

Medical radiography
Radiography
Flouroscopy
Radiography
Flouroscopy
Diagnostic uses of
radiopharm.
Annual per
Capita Dose
for Exposed
Population
(mrem)






138
296
153
328
Depends on
radiopharm.
Size of
Exposed
Population
(thousands)






66,900)
7 780 /
75, 400 )
8,600 f
1, 500
Annual per
Capita Dose
Fraction of for Whole U.S.
Whole U.S. Population
Population (mrem)

55
36C
5
0.3

0.40 61
0.42 72°
0.008 1
                                                     (continued)

-------
                                            Table 1II-5 (continued)
o
to
Dose Category
or Organ
Whole-body dose
occupational (1968)
Source
Medical workers
Dental workers
Radiopharm. and
radium workers
Annual per
Capita Dose
for Exposed
Population
(mrem)
320 1
125 |
262-540!
Size of
Exposed
Population
(thousands)
454
Fraction of
Whole U.S.
a
Population
0.002
Annual per
Capita Dose
for Whole U.S.
Population
(mrem)
0.6
     Organ
       Thyroid (1964)
     Thyroid (1966)
Medical radiography
  Examinations of
  head and neck
  Examinations of
  chest and thorax

Dental radiography

Diagnostic uses
of radiopharm.
  131
     I thyroid function
                                                        172

                                                         69

                                                         57
 7,500

51,100

45,900
0.31


0.25
26


14
                                                             3e)
function
I thyroid scan
Other
5t°15Xf 1,500 0.008
78x10 >
Depends on
radiopharm.
143
      Based on civilian non-institutionalized population only.
      GSD applicable to whole United States population.
     "Preliminary information.
      Ovarian and "simulated ovarian" doses.
     ^Based on recommended activity per administration.

-------
doses from dentistry and radiopharmaceuticals were  small; less than 1
mrem for dentistry  (1964) and 0.3 mrem for radiopharmaceuticals  (1966).
The GSD (1966) from radiotherapy was estimated  to be  5 mrem.  Preliminary
reports have stated that the GSD has decreased  from the  1964 level to
35.5 mrem in 1970.   A large portion  (30%) of the GSD in 1964 was due
to lumbo-sacral and lumbar-spine examinations of males in the 15- to 29-
year age group.  This examination-age-sex group also  accounts for approx-
imately 70% of the difference in the GSD between 1964 and 1970.  The
small number of examinations in this category for which  testicular doses
were actually measured, and the nature of the distribution of the data,
has introduced reservations concerning the conclusiveness of the results.
     Another index of medical radiation dose used in  this report is the
per capita abdominal dose.  This index is calculated  from dose estimates,
ovarian (for females) and "simulated ovarian"  (for  males), weighted for
their representation in the United  States population.  Because the entire
population regardless of age is employed, the data  are not weighted for
future child-bearing potential, and the dose estimates are not sensitive
to small variations in beam size and position;  the  difficulties encountered
in determination of GSD are reduced.  Furthermore,  one is able to calculate
dose estimates for  the exposed population  (i.e., considering only persons
receiving x-ray examinations).  The annual per  capita abdominal depth  dose
for the exposed population in 1964  was 138 and  296  mrem  from medical radio-
graphy and fluoroscopy. respectively.  In 1970, based on preliminary in-
formation, the abdominal dose due to medical radiography appears to have
risen.  This increase, due entirely to an elevation of the female per
capita abdominal dose, requires elucidation.  For the whole United States
population, the annual per capita abdominal doses for 1964 and 1970 are
estimated to have been 61 and 72 mrem, respectively.  Errors in  the survey
and the measurements from which these estimates were  derived have not, as
yet, been fully evaluated.  Accordingly,  it appears that the most prudent
conclusion is that  this index has remained relatively stable during the
two study years.
     Estimates of whole-body dose may also serve as an index of  somatic
dose.  Whole-body doses from radiopharmaceuticals may be relatively high
                                   103

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(approximately 1 rem)  to individuals experiencing a particular procedure;

however,  because the number of persons so treated is still relatively


small,  the accrued dose to the whole population is small.

     Among specific organs which may be exposed in the course of medical


treatment, present information permits estimates of thyroid dose.  The
                                                                131
highest thyroid doses  are delivered to individuals experiencing    I


thyroid function and scan tests who receive an estimated per capita dose

of 5 to 15 rem to this organ during a thyroid function test and 78 rem


during a thyroid scan.  The introduction of in vitro thyroid function


tests and new radiopharmaceuticals will significantly lower these doses.

Although the population receiving such procedures is small, the annual


per capita thyroid dose to the whole United States population (1966) from

radiopharmaceuticals is estimated at 143 mrem.  This is greater than the

corresponding estimated annual per capita doses to the whole population

(1964)  of 26 mrem from medical x-ray examinations of the head, neck, chest,

and thorax and 14 mrem from dental radiography.

     A word should be  said about occupational doses associated with the

delivery of medical x-rays and therapy.  Estimated annual  per capita doses

(1968)  to exposed groups of workers range from 125 mrem for occupational

dental exposure to 540 mrem for persons employed in administration of

radium therapy.  As a  group, medical workers contribute a  greater portion

to overall population  dose than any other occupational group, and experience

a higher annual per capita dose than any other occupational group.

     Among pertinent information required for a more complete evaluation of


radiation doses to the United States population from the healing arts, but

as yet, still lacking  are bone marrow doses from the medical radiation

sources.   Also, doses  from the treatment of nonmalignant diseases with radia-


tion, and doses to particular populations at maximum risk due to specific

chronic illnesses are  also not available.


     Projection of doses from diagnostic medical radiography must take


into consideration changes in the rate of delivery of radiographic exam-


inations, in the age and sex distribution of the patients, in the distri-


bution of examinations by type, and in dose per examination.  Review of


several reports on the rate of increase of radiographic examinations, each




                                    104

-------
using different measurement parameters, leads to the conclusion that in
the past decade the rate of radiological examinations increased between
1 and 4% per year.  At least some of this  increase appears to be due to
the expansion of radiographic services to  persons who previously did not
have such care available.  Furthermore, there is some evidence of tech-
nical improvements, and it is reasonable that as much as a 50% reduction
in dose might be possible due to technical and educational methods.  Thus,
it appears that the potential for technical  improvement could keep pace
with increased usage.  Based on the evaluations presented in this report
of the Public Health Service surveys of 1964 and 1970, it appears that
the reported changes in the GSD are, at present, uncertain and require
further elucidation.  An evaluation of abdominal dose, based on these
same surveys, leads to the conclusion that the level of population dose
between 1964 and 1970 from diagnostic medical radiology has not changed
greatly.  Considering the above factors, the man-rem dose from diagnostic
medical radiation would increase only through population increase.  An
annual per capita abdominal depth dose  (an index of somatic dose) of 72
mrem in 1970 would yield an estimated 14.8 million man-rem to the whole
United States population.  Increasing population alone would raise this
to 23.1 million man-rem by the year 2000.
     Compared to diagnostic medical radiography, estimated future accrued
man-rem doses to the United States population from other medical uses of
radiation are small.  Only the diagnostic  uses of radiopharmaceuticals,
which by the year 2000 could accrue a whole-body man-rem dose of greater
than 3.3 million man-rem to the population,  is significant.  The corres-
ponding accrued man-rem doses from dentistry and medical occupational
exposure in the year 2000 are 200,000 man-rem each.
     Extrapolations and projections made in  this study must be considered
in light of the uncertainties surrounding  the base measurement, the assump-
tions employed, and the changing state of  medical technology.  Despite
these reservations, medical radiation is the largest manmade component of
radiation dose to the United States population.  It accounts at present,
on the basis of the indices employed in this study for at least 90% of
the total manmade radiation dose and at least 35% of the total radiation
                                    105

-------
dose (including natural background) to which the United States population
is exposed.  Conclusive evidence that doses from diagnostic medical radio-
graphy has either increased or decreased in the past decade is lacking.
Based on the information presently available and discussed in this re-
port, it is logical to conclude that the annual per capita population
dose from diagnostic medical radiography could remain stable if tech-
nical improvements keep pace with increased usage rates.
                                    106

-------
                                 REFERENCES

 1.  Public  Health  Service.   1969.   Population dose from X-rays,  U.S.
    1964.   Washington,  Publ.  No.  2001.   xiv,  143 pp.

 2.  Gileadi,  M.  1969,   Evaluation of health hazards  due to unintentional
    irradiation  of the  gonads during routine abdominal X-ray examinations
    of male and  female  patients in Puerto Rico,  Report I-Western Region.
    Puerto  Rico  Nuclear Center, U.S. AEC report  PRNC-132   105 pp.

 3.  Izenstark, J.L.  and W.  Lafferty.  1968.   Medical  radiological practice
    in New  Orleans;  estimates and characteristic? of  visits, examinations,
    and  genetically  significant dose.  Radiology 90:   229-242.

 4.  Pasternak, B.S.  and M.B.  Heller.  1968.   Genetically significant  dose
    to the  population for New York City from diagnostic medic;?!  radiology.
    Radiology 90:   217-228.

 5.  Cooley, R.N. and L.B. Beentjes.   1964.  Weighted  gonadal diagnostic
    roentgen-ray doses  in a teaching hospital with comments on X-ray
    dosages to the general  population of the United States.  Am, J.
    Roentgenol., Had. Therapy Nucl.  Med. 90:   404-417.

 6.  Morgan, R.H. and J.C. Genret.   1966.  The radiant energy received by
    patients in  diagnostic  X-ray practice.  Am.  J, Roentgenol,,  Rad,
    Therapy Nucl.  Med.  97;   793-810.

 7.  Billings, M.S.,  A,  Norman and M.A.  Greenfield.  1957,  Gonad dose during
    routine roentgenography.   Radiology 69:   37-41.

 8.  Laughlin, J.S. and I. Pullman.  1957.  Gonadal dose produced by the
    medical use  of X-rays,  preliminary edition of section III.  National
    Academy of Sciences-National Research Council, Washington.  105 pp.

 9.  Brown,  F.R., J.  Heslep and W.  Eads.  1960.  Number and distribution
    of roentgenologic examinations of 100,000 people.  Radiology 74:   353-
    362.

10.  Norwood, W.D., J.W. Healy, E.E.  Donaldson, W.C. Roesch and C.W. Kirklin.
    1959.   The gonadal  radiation dose received by the people of a small
    American city  due to the diagnostic use of roentgen rays.  Am.  J.
    Roentgenol., Rad. Therapy Nucl.  Med. 82;  1081-1097.

11.  Gitlin, J.N.  1972,  Preliminary dose estimates from the U.S. Public
     Health Service 1970 X-ray exposure study. Paper presented at the  49th
    Annual  Meeting of the American College of Radiology, Miami Beach,
    Florida, April 6, 1972.
                                    107

-------
12.  Gitlin, J.N. and P.S. Lawrence.  1968.  Population exposure to X-rays.
     U.S. 1964.  U.S. Public Health Service, Washington, Publ. No. 1519.
     x, 218 pp.

13.  Roney,  P.L.   1972.   Personal  communication,  April 24,  1972.  Bureau
     of Radiological Health,  Food  and Drug Administration,  Department of
     Health, Education,  and Welfare.

14.  Goldstein, N. and J. Gaskill.   1972.   Personal communications,
     February 11, 1972 and April 17,  1972. Bureau of Radiological Health,
     Food and Drug Administration,  Department of Health, Education,  and
     Welfare.

15.  Fess,  L.R.,  R.B. McDowell,  W.R.  Jameson and R.W. Alcox.   1970.
     Results of 33,911 X-ray protection surveys of facilities with
     medical or dental diagnostic  X-ray equipment, fiscal years 1961-
     1968.   Radiological Health Data 11(11):  581-612.
16.  Richards,  A.G.  and R.L.  Webber.   1964.   Dental X-ray exposure of
     sites within the head and neck.   Oral Surg.  18:   752-756.

17.  Public Health Service.   1970.   Diagnostic dental X-rays and the
     patient - an overview.   Radiological Health Data 11(1):  1-5.

18.  Clark, S.H,  1956.  Genetic exposure in the field of medicine.  Bull.
     Atomic Scientists 13:  14.

19.  Chamberlain, R.H.  1957.   p. 885.  In:   Radioactive Fallout and Its
     Effects on Man.   Hearings before the Special Subcommittee on Radia-
     tion, Joint Committee on Atomic Energy, U.S. Congress, May 27, 28,
     29,  and June 3,  1957.  Washington.

20.  Public Health Service,   1970.   Survey of the use of radionuclides in
     medicine.   (Prepared by Stanford Research Institute).  Bureau of
     Radiological Health report BRH/DMRE 70-1.  xxii, 132 pp.

21.  Maynard,  C.D.  1969.  Clinical Nuclear Medicine.  Lea and Febiger,
     Philadelphia.  xiii, 280 pp.

22.  Hine, G.H. and R.E. Johnson.  1970.  Technical communication.  J. Nucl,
     Med. 11:   468.

23.  Christine, B.W., P.O. Sullivan and R.R. Connelly.  1970.  Cancer  in
     Connecticut 1966.  Connecticut State Department of Health, Health
     Bull. 84.

24.  National Institutes of Health, National Cancer  Institute.  1971.
     Unpublished information provided through the courtesy of Dr. S. Cutler
     and Mrs.  Axtell, End Results Group, End Results Section.  Washington.


                                   108

-------
25.  Ministry  of  Health.   1960.   Radiological  hazards  to patients,
     second  report  of  the  Committee.   Department  of Health for Scotland,
     London.   114 pp.

26.  Cipollaro, A.C. and P.M.  Crossland.   1967.   X-rays  and Radium  in  the
     Treatment 
-------
37.  LeBlanc,  A. and P.C. Johnson.   1970.   Medical radiation exposure
     survey in a hospital with a nuclear medicine laboratory.  Health
     Physics 19:  433-437.

38.  Atomic Energy Commission.  1971.   The nuclear industry.1971.
     Washington.  vii,  199  pp.

39.  Public Health Service.   1970.   Health resources statistics,  1969.
     National  Center for Health Statistics,  Washington,  Publ. No.  1509
     vi,  286 pp.
                                  110

-------
       APPENDICES



           TO



MEDICAL RADIATION SECTION
         111

-------
        APPENDIX III-A

Summary of Information Relating
 to United States Studies for
     Determination of GSD
               113

-------
Table IIIA-1
Summary of
Study and Location
Public Health
Service/National

Izenstark & Lafferty/
New Orleans , La?

Pasternak & Heller/
New York, N.Y^

Cooley & Beentjes/
Galveston, Tex.

Morgan & Gehret/
Baltimore, Md?

Billings, Norman, &
Greenfield/
Los Angeles, Calif.
Laughlin & Pullman®

Information Relating
Year
1964

1962-
1963

1962

1964

1963-
1964

Prior
to
1957
1957

Approx . No .
Persons
x rayed or
Exams .
4,500

8,000
persons

Not
reported

220,000
exami-
nations
36,000
persons

900
persons
_

to United States Studies
Site or
Sampling See
Source Footnotes
Household a,b,c
interview

Hospitals & c
offices

Gen . , TB & a,c
mental hosp . ,
clins . , of f s .
University a,b,c
hospital

Teaching a,c
hospital

Large private & d
general hosp . ,
childrens clin.
Based on a,b,d
published
literature
for Determination of
Source of Popu-
lation Age Dis-
tribution Data
Study
itself

Study
itself

NYC
Census-
1960
U.S.
Census-
1960
U.S.
Census-
1960
Study
itself
_

GSD
Source of Age-
Specific Child
Expectancy Data
National Center
for Health Sta-
tistics, 1963
National Center
for Health Sta-
tistics, 1963
Not reported

U.S. Vital
Statist ics -
1960
National Center
for Health Sta-
tistics, 1963

"
American Medi-
cal Directory,
1950, 1956
 (continued)

-------
                                       Table IIIA-1 - continued



Study and Location
Brown, Heslep, & Eads/
San Francisco, Calif.

Norwood, Healy,
Donaldson, Roesch, &
Kirklin/
Richland, Wash.



Year
1956-
1957

1953-
1956

Approx . No
Persons
x rayed or
Exams .
110,000
exami-
nations
85,000
exami-
nations

Site or
Sampling
Source
Medical ins.
hospital

Hospital &
offices


Source of Popu-
See lation Age Dis-
Footnotes tribution Data
a,d Study
itself

a,b,c,d Study
itself


Source of Age-
Specific Child
Expectancy Data
-

Study itself


 Flouroscopy included.


 Dentistry included.

Q
 GSD based on age distribution anr" child expectancy.


 GSD equivalent to 30-yr. gonad dose.

-------
                                           Table IIIA-2
Summary of Information Relating to United States Studies for Determination of GSD
Study and Location
Public Health
Service/National
Izenstark & Lafferty/
New Orleans, La.
Pasternak & Heller/
New York, N.Yi
Cooley & Beentjes/
Galveston, Tex~

Morgan & Gehret/
Baltimore, Md?


Billings, Norman, &
Greenfield/Los Angeles,
Calif?
8
Laughlin & Pullman
Brown, Heslep, & Eads/
San Francisco, Calif?
Norwood, Healy, Donald-
son, Roesch, & Kirklin/
Richland, Wash*0
Actual Measure-
ment of X-ray Method of Measure-
Machines Made ment of X-ray
Dose Model During Study Machines During;
Employed Yes No Study
Phantom & human x - Various film packs
subjects depending on procedure
Phantom X
Model based on - X
phantom
Phantom, human X - Assortment of ioniza-
subjects & tion chambers and/or
published lit, monitoring films
Calculational (rela- X - Differential-type
tionship between ionization chambers
abdominal & gonad
dose)
Phantom & human X
subjects
Based on published X
literature
Based on published X
literature
Phantom & Partial - Ionization chambers
published
literature
GSDa
(mrem)
55
(New 75
Orleans)
(New York 50
City)
18

23


(L.A. 61
hospi tal )
(probable) 136
(minimum) 50
40
(Richland) 46

For U.S. population unless otherwise stated.  Not differentiated between estimates to population
less than 30 and whole population.

-------
                            APPENDIX  III-B


                      Estimated Thyroid Dose - 1964


                     A.   Head  and Neck Examinations




                    12
1.  27,069,000 films   or 7,519,166 examinations assuming 3.6 films per

    examination.



2.  Mean skin exposure (skull,  mastoid,  optic, mandible,  and sinuses) = 279

    mR per examination^2



3.  Assume that the skin dose  and dose to the lens of the eye are equiv-

    alent .



4.  Ratio of lens of eye to thyroid exposure:

                       16
    14 periapical films


    @ 65 kVp 2.1:1.3 = 1.61

    @ 90 kVp 79:48 = 1.64.


    279 mR lens of eye/examination   ^ _„     ,       . ,      .     ......
5.  	1—~	— = 172 mrad thyroid dose/examination*
                  1.62

                                                              9
6.  7,519,000 examinations x 172 mrad/examination _ 1,293 x 10
                      _.                 _          — _   .  mra

              187 x 10  whole  population             187 x 10     annual

                                                                  per capita

                                                                  thyroid dose.



                     B.   Chest Examinations



1.  Assume ratio of skin to thyroid dose from chest examinations same

    ratio as skin to male gonad doses  from abdominal examinations.



    Abdominal mean male gonad  dose/film  _ 273 mrad _      abdominal gonad

       ...  .  n        i •   j    /j. • -,  12     790 mrad    '    abdominal skin
       Abdominal mean skin dose/film



2.  Mean skin dose - chest x rays:


                                   12
    Chest (photofluorographic)/film   = 500  mrad.

         Estimated thyroid dose       = 170  mrad.


                             12
    Chest (radiographic)/film          = 45 mrad.

         Estimated thyroid dose       = 15 mrad.



3.  Dose 1963:


                                        12
    No. chest films (photofluorographic)   (1964) = 16,800,000 x 170 mrad

                                                  = 2,900,000 rad.




 Assumes mR and mrad to be equivalent.



                                     118

-------
                                  12
    No.  chest films (radiographic)   (1964) = 46,800,000 x 15 mrad
                                            = 702,000 rad
                                      Total = 3,600,000 rad.

    3,567,730 patient-rad  (1964)
     51,100,000 persons at risk   = °'069 rad  = 69 mrem to person in
                                                 exposed population.

    51,100,000 exposed population x 69 mrem
    	 = 0.27 x 69 = 19 mrem mean
      187 x 10  total population                          annual per capita
                                                          dose to whole
                                                          population.

                    C.  Dental Examinations
1.  226.7 x 106 films/yrl7

2.  Distribution by film use    (percent).

    Film type      Bite wing	Periapical
A
B
C
D
3
48
17
32
3
47
18
32
3.  Distribution of film use by type of film    (percent)

    Periapical      67
    Bite wing       33

4.  Thyroid dose per film  (mrem).
           Bite wing                 Periapical
      Film SpeedDose           Film Speed   Dose
         A         44               A         27.2
         B         22               B         13.6
         C         11               C           6.817
         D          5.5             D           3.4

5.  Dose (1964):
                           JJ J- L-C: W J-IIg,

     226,7 x 106 x 0.33   (0.03 x 44) +  (0.48 x 22) +  (0.17 x 11) +  (0.32 x 5.5)
                                          6  —  —
                                 45.9 x 100
   = 25.279 mrem mean annual dose to person in population at risk.
                                     119

-------
                                 Periapical


    226.7 x 106 x 0.67  (0.03 x 27.2) + (0.47 x 13.6) + (0.18 x 6.8)  +  (0.32  x 3.4)
D _           _.......   ~45.9 x 10b '



  = 31.502 mrem mean annual dose to person in population at risk.

             6
    45.9 x 10  exposed persons   .._ __
    ——	       r	:;——	 x 56.78 mrem = 13.93 mrem per capita to  population
    187 x 106 total  population                            ,
                                                    as a whole.
                                    120

-------
                                   APPENDIX III-C
                                Radiopharmaceut icals
                                   Table  IIIC-1
)
Patient
Administration and Dose Administered - 1966

Radionuclide and Form
131T
I
Nal
Nal
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin (MAA)
Sodium lodohippurate
Sodium lodohippurate
Labelled fats
Rose Bengal
Rose Bengal
125
I
Nal
Other radionucl ides
57
Co Labelled Vita-
min B-^2
60
Co Labelled Vita-
min B-^2
51
Cr Sodium chromate
51
Cr Sodium chromate
Estimated number
of patient
administrations
Procedure (1966)


Thyroid uptake
Thyroid scanning
Blood volume
Cardiac output
Placental scanning
Brain scanning
Heart scanning
Liver scanning
Lung scanning
Renal function
Kidney scanning
Fat malabsorption
Hepatic function
Liver scanning


Thyroid scanning



Vitamin B absorption


Vitamin B12 absorption
Blood volume

Red blood cell survival


481,
252,
163,
2,
6,
6,


37,
53,
3,
12,
1,
32,


2,



39,


26,
36,

10,


830
567
418
527
753
077
675
337
817
069
376
635
685
415


026



591


113
221

108
Dose
administered
(nCi/70-kg
adult)


27.5
45.7
5.5
20
7.1
400
300
157.7
260.4
45.0
200
44.4
10
150


75



0.50


0.50
27.3

100
51
59
Cr Heat-treated red
   blood cells
Fe chloride or
   citrate
                        Spleen scanning
                        Iron turnover
2,701

5,054
225

  7.5
                              (continued)
                                    321

-------
                              Table IIIC-1 - continued
Radionuclide and Form
99m
Tc pertectnetate
99m
Tc pertectnetate
99m
Tc sulfur colloid
99m
Tc labelled albumin
99m
Tc labelled albumin
198 :
Au colloidal gold
203
Hg labelled mer-
curials
203
Hg labelled mer-
curials
197
Hg labelled mer-
curials
197
Hg labelled mer-
curials
Mercurihydroxipropane
85
Sr nitrate or chlo-
ride
75
Se selenomethiodine
Procedure

Brain scanning

Thyroid s-canning

Liver scanning

Placental scanning

Lung scanning

Liver scanning


Brain scanning


Kidney scanning


Brain scanning


Kidney scanning
Spleen scanning


Bone scanning

Pancreas scanning
Estimated number
of patient
administrations
(1966)

103,998

337

4,911

205

205

68,881


62,128


27,012


30,389


11,480
675


675

2,701
Dose b
administered
(liCi/70-kg
adult)

7,936

2,000

2,971

1,000

1,000

175


700


116


1,000


144
300


2,000

125

.6



.6





.0



1

.6





.4






 Represent returns"" from 54% of queried,  corrected to estimate total patient


 administrations.                                                        i

b
 Values stated to  one decimal place  from Reference 20.  Mean dose is average


 representative of all physicians performing procedure.  Assumes a 70-kg adult

                     131
 patient,  except for    I,  where weighted average was used.  Other values

                                  21,22
 represent  median dose  recommended^
                                        or values  from manufacturer's literature.
                                         122

-------
                                            Table  III-C-2


                                       Dose per Administration
to
co

Dose (mrad) *
Radionuclide and form
131z
Nal
Nal
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Labelled albumin
Sodium iodohippurate
Sodium iodohippurate
Labelled fats
Rose Bengal
Rose Bengal
125
Nal
Other Radionuclides
Co labelled Vitamin ¥>
fin
Co labelled Vitamin B
51
Cr sodium chromatt
Procedure
Thyroid uptake
Thyroid scanning
Blood volume
Cardiac output
Placental scanning
Brain scanning
Heart scanning
Liver scanning
Lung scanning
Renal function
Kidney function
Fat malabsorption
Hepatic function
Liver scanning
Thyroid scanning
Vitamin B absorption
Vitamin B absorption
1 *j
Blood volume
Whole body
55
91
11
40
14
800
600
315
65
5
24
29
7
105
3
1.75
210
5.5
Gonad
69
114
30
110
39
2,200
1,650
867
208
25
-
-
-

50
280
6.8
Thyroid
46,750
77,690
193
800
248
14,000
10,500
5,519
9,110
1,575
7,000
-
-
67,500
-
                                                         (continued)

-------
                                        Table IIIC-2  -  continued
Dose (mrad)
Radionuclide and form
Cr sodium chromate
51
Cr heat-treated red
blood cells
59
Fe chloride or citrate
Tc pertectnetate
99mm
Tc pertectnetate
99m
Tc sulfur colloid
99m
Tc labelled albumin
99m
Tc labelled albumin
198
Au colloidal gold
203
Hg labelled mercurials
203
Hg labelled mercurials
197
Hg labelled mercurials
197
Hg labelled mercurials
Mercurihydroxipropane
85
Sr nitrate or chloride
87m
Sr nitrate or chloride
75
Se Selenomethiodine
Procedure
Red blood cell survival


Spleen scanning

Iron turnover
Brain scanning
Thyroid scanning
Liver scanning

Placental scanning

Lung scanning
Liver scanning

Brain scanning

Kidney scanning

Brain scanning

Kidney scanning
Spleen scanning

Bone scanning

Bone scanning

Pancreas scanning
Whole body
20


67

225
119
30
44

15

15
218

1,050

175

100

14
42

1,312

20

1,000
Gonad
25


450

1,125
198
198
297

40

40
87

630

630

80

11
36

-

-

625
Thyroid
-


-

-
2,831
600
-

-

-
-

-

-

-

-
-

-

-

750
                                                9 o
^Product of activity per administration and dose   to specific organ per unit activity.

-------
                          APPENDIX  III-D
                          Radiation  Therapy

                           Table III D-l
Exposed
Population
Radiat
ion Therapy (Malignancies) Age <30

ICS No.
140 - 149
151
153
154
155
157
160
162
163
170
171
172
174
175
177
178
180
181
181.7
190
192
193
193.1

194
195
197
199
Lymphatic
Leukemia
Rate/100
in Conn.23
,000
1966
Male Female
1
-
1
1
-
-
1
1
2
-
-
-
2
11
2
1
1
9
2
9
4

5
1
8
2
19
18
-
1
3
1
1
1
-
-
1
1
110
3
3
7
-
2
-
-
9
1
13
4

8
1
7
3
17
12
Expected number
of cases in U.S „*
Site
Buccal cavity & pharynx
Stomach
Large intestine
Re c t urn
Liver, bile duct
Other; digestive
Nose and nasal cavity
Lung bronchio-tracheal
Other, respiratory
Breast
Male
553.8
_
553.8
553.8
-
-
553.8
553.8
1,107.6
-
Female

538.3
1,615.0
538.3
538.3

-

538.3
538.3
Uterus (excluded from genetic dose)



Prostate
Other male genitals
Kidney
Bladder
Other urogenital
Malignant melanoma
Eye
Brain
Other central nervous
system
Thyroid
Other endocrine
Connective tissue (b'one)
Other
Lymph
Leukemia





1,107.2
553.8
553.8
4,984.2
1,107.6
4,984.6

2,215.2
2,769.0
553.8
4,430.4
1,107.6
10,522.2
9,968.4





1,077.2
-
-
4,845.0
538.6
6,997.9

2,153 .3
4,306.6
538.3
3,768.3
1,615.0
9,151.1
6,460.0
^Estimated Population to Age 30  (1970):
  Male; 55,385,000
Female; 53,833,000.
                                  125

-------
                                                   Table III -D-2
to
Treatment of Cancer (Diagnosed 1955-1964) with Radiation3 - Age <30

Treated with
Radiation
All Cases
Site
Lip
Tongue
Salivary gland
Floor of mouth
Mouth (other)
Oral mesopharynx
Nasopharynx
Hypopharynx
Pharynx , NOS
Esophagus
Stomach
Small intestine
Large intestine
Rectum
Liver/gallbladder
Pancreas
Peritoneum
Digestive, NOS
Nose, nasal cavity,
ear, etc.
Number
22
17
379
3
23
10
62
2
3
1
40
36
305
51
73
32
8
1
50
Percent
0.2
0.2
3.4
0.1
0.2
0.1
0.6
0.1
0.1
0.1
0.4
0.3
2.8
0.5
0.7
0.3
0.1
0.1
0.5
Number
3
8
19
3
6
9
53
2
2
1
9
14
7
3
14
6
5
1
33
Percent-
age of
Cases
14
47
5
100
26
90
85
100
67
100
22
39
2
6
19
19
62
100
66
Relative Survival Rate

(%)
All Cases Radiation Treated
3 yr.
95
-
97
-
-
-
(37)
-
-
-
(16)
(32)
76
(48)
15
(21)
-
-
(53)
5 yr. 3 yr. 5 yr.
95 -
_ _
94 (79) (79)
_ _
_
- -
(31) (35) (35)
- -
_
_
- -
(32)
71 - -
(42)
13 - -
(21)
- -
- -
(45) (50)
                                                        (continued)

-------
                                 Table III D-2 (continued)
Treated with
Radiation
Site
Larynx
Bronchus , lung
Mediastinum
Breast
Cervix, uteri
Corpus, uteri
Ovary, fallopian
tubes , etc .
Vulva, vagina
Prostate
Testis
Penis, other
male genitals
Kidney
Bladder
Other, urinary
Lower GI, NOS
Melanoma
Other skin
Eye
Brain, other nervous
All
Number
15
89
89
195
351
37
186
19
12
327
12
278
88
7
0
369
264
381
1.600
Cases
Percent
0.1
0.8
0.8
1.8
3.2
0.3
1.7
0.2
0.1
3.0
0.1
2.5
0.8
0.1
-
3.3
2.4
3.5
14.5
Number
8
30
62
81
215
9
85
5
8
175
0
216
9
0
0
9
24
125
811
Percent-
age of
Cases
53
34
70
42
61
24
46
26
67
54
—
78
10
-
-
2
9
33
51
Relative Survival Rate

(%>
All Cases
3 yr.
(91)
(41)
(33)
53
72
(86)
68
-
-
52
-
41
84
-
-
70
95
86
38
5 yr .
-
(36)
(31)
44
67
(86)
64
-
-
51
-
40
84
-
-
64
92
84
33
l

Radiation Treated
3 yr.
-
(18)
(37)
(38)
57
-
(59)
-
-
52
-
38
-
-
-
-
(82)
82
34
5 yr .
-
(11)
(33)
(29)
53
-
(52)
-
-
50
-
38
-
-
-
-
(82)
81
28
system
                                             (continued)

-------
                                            Table III-D-2 (continued)
M
00
Treated with
Radiation
Site
Thyroid
Other endocrine
glands
Bone
Connective tissue
Ill-defined sites
Lympho/reticulo
sarcoma
Hodgkins disease
Other lymphoma
Multiple myeloma
Leukemia
Mycosis fungoides
ALL SITES COMBINED
All
Number
613
233
485
444
169
413
904
100
5
2,167
5
11,034
Cases
Percent
5.6
2.1
4.4
4.0
1.5
3.7
8.2
0.9
0.1
19.6
0.1
100
Number
143
143
252
137
37
260
678
34
2
165
1
3,976
Percent-
age of
Cases
23
61
52
31
51
63
75
34
40
8
20
36
Relative Survival Rate

(%)
All Cases
3 yr.
97
34
32
52
13
24
52
40
-
4
-

5 yr.
96
32
28
50
13
18
31
37
-
3
-


b
Radiation Treated
3 yr.
94
34
24
27
14
26
55
(43)
-
3
-

5 yr .
92
32
19
26
14
20
34
(43)
-
3
-

         aRadiation alone or in combination with other therapy.

          Rates in parentheses have standard error between 5 and 10%.  Rates with standard errors
          larger than 10% not shown.

-------
                  Table  III  D-3

                                        25
      Estimated  Gonad  Dose per Treatment

Site
Buccal cavity and pharnyx
Stomach
Large intestine
Rectum
Liver and bile duct
Nose and nasal cavity
Breast
Lung, bronchi and trachea
Other respiratory
Kidney
Bladder
Melanoma*
Eye
Brain
Other central nervous system
Thyroid
Other endocrine
Connective tissue*
Lymphoma*
Leukemia*
Dose
Male
0.22
9.07
212.09
385.2
5.38
0.51
-
2.05
2.05
44.74
262.59
88.37
0.2
0.4
0.4
0.45
44.74
141.39
123.72
123.72
(rem)
Female
0.25
16.94
-
-
10.04
0.57
7.79
5.94
5.94
-
71.71
150.0
0.22
0.44
0.44
1.0
405.0
240.0
210.0
210.0
— — A	 -              r

abdomen, pelvis or upper thigh.
                         129

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                                                     Table III -D-4
oo
c
Gonad Dose
from Radiation
Therapy of Malignancies to the Less Than 30 Age Group

Site
Buccal cavity
and pharynx
Stomach
Large intestine
Rectum
Liver, bile duct
Nose and nasal
cavity
Breast
Lung, bronchi and
trachea
Other respiratory
Kidney
Bladder
Other urogenital
Melanoma
Eye
Brain
Other central
nervous system
Product of Percent-
age of Population <30
Treated by Radiation &
10-year Survival Rate
0.10
0.04
0.01
0.03
0.03
0.33
0.12
0.04
0.48
0.30
0.08

0.01
0.26
0.14
0.14
(0.145
(.22 x
(.02 x
(.06 x
(.19 x
(.66 x
(.42 x
(.34 x
(.53 x
(.78 x
(.10 x

(.02 x
(.33 x
(.51 x
(.51 x
x .70)
.16)
.70)
.50)
.14)
.50)
.29)
.11)
.91)
.38)
.84)

.64)
.81)
.28)
.28)
Estimated Population
<30 Having Malignancy
Receiving Radiation,
& Surviving >5 Years
Male
55
-
5
17
-
183
-
22
532
332
44
-
50
288
698
310
Female
-
21
16
16
16
—
66
-
258
323
-
-
48
140
980
301
j
Gonad
(patient-rem per year)
Male
12.1
-
1,060.4
6,548.4
-
93.3
-
45.1
1,090.6
14,840.4
11,554.4
-
4,420.0
57.6
279.2
124.0
Female
-
355.7
3,393.6
6,163.2
160.6
~
514.1
—
1,532.5
14,438.1
-
-
7,200.0
30.8
431.2
132.4
                                                      (continued)

-------
Table III D-4  (continued)
Estimated Population
Product of Percent- <30 Having Malignancy
age of Population <30 Receiving Radiation,
Treated by Radiation & & Surviving >5 Years
Site
Thyroid
Other endocrine
Connective tissue
Lymphoma
Leukemia
Other
TOTAL
10-vear Survival Rate
0
0
0
0
0
0

.21
.19
.08
.25
.02
.14

(.23 x
(.61 x
(.31 x
(.34 x
(.08 x


.92)
.32)
.26)
.75)
.03)


Male
581
105
353
2,631
199
155
6,560
Female
904
102
301
2,288
129
226
7,814
t
Gonad
(patient-rem per year)
Male

4,
49,
325,
24,
13,
448,
261
693
914
454
616
697
363
.4
.5
,2
.7
.3
.3
,9

41
72
480
27
33
690
Female
904.0
,310.0
,240,0
,480,0
,090,0
,900.0
,276.2

-------
                      Table  III D-5
Estimated GSD from Radiation Therapy (Malignant Diseases)

Area of Body
Male genitals
Male pelvic region
Male - other
Female pelvis (bladder,
cervix, rectum, and
kidney)
Female pelvic region
Female - other
Fertility
Index Annual Cumulative
Relative or. Patient-rem
to Normal""' Male Female
0.02
0.40 490,670
1.0 1,936
0.0
0.4 - 681,184
1.0 - 3,545
Annual Cumula-
tive Patient-
rem Corrected
for Fertility
-
196,268
1,936

272,473
3,545
M , 474,249 patient-rem _ n
Note- 	 	 	 5 1 m-rom
 93.5 x 10  population under 30
                            132

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IV.  OCCUPATIONAL DOSES

-------
                      IV.  OCCUPATIONAL RADIATION

     The contribution of occupational exposure to the population dose
from ionizing radiation is poorly documented in the scientific litera-
ture.  Despite the lack of published information, a vast quantity of data
has been accumulated in various personnel dosimetry programs throughout
the United States.  Most of the information from these programs has been
made available for this study.  The purpose of this section is to provide
mean dose estimates for various occupational specialities, an estimate of
the total number of radiation workers in the population, and an estimate
of the contribution of occupational exposures to the United States popu-
lation dose.
     A.  Assumptions and Limitations of Data
     In general, the data collected by the various reporting agencies
were primarily for verification of the adequacy of radiation protection
practice and to preclude, where possible, overexposure of the worker.  The
retention of the data by the employer is, in most instances, for medico-
legal purposes.  There is no requirement for uniformity in collecting or
reporting of all occupational exposures to ionizing radiation nor are
there any required standards for accuracy.
     In consideration of the foregoing, the data collated by major report-
ing agencies will be treated separately.  In numerous instances,the major
reporting agency includes data from other agencies through joint agree-
ments to provide personnel dosimetry service.  Where possible, these will
be shown.
     Except where indicated, the doses are from external sources.  Infor-
mation on dose from internal sources during occupational exposure is
limited and is reported only for special categories.  The terminology
used by the reporting agencies is extremely varied.  It has been assumed
that the value reported is the exposure of the dosimetry device and no
                                     135

-------
attempt has been made to calculate a true absorbed dose.  Additional
complications in assessing a true dose are variations in placement of
the dosimeter on the individual and variations in the terminology used
in reporting results; i.e., reports made in roentgens, rad, and rem.
For the purposes of this report, the value reported is considered to
be accurate; to be a whole-body dose and is assumed to be the dose equi-
valent in rem.  It is intended that the use of dosimeter exposure results
as dose equivalent will result in an overestimate of the actual whole-
body dose .
     With the exception of data obtained from the Army and Navy, all re-
sults were provided in dose ranges.  For the purpose of calculating total
man-rem,  the midpoint of the ranges were taken to be the mean for the
entire range.  Since there is a tendency to badge for convenience, and
for legal purposes, it has been reported that in most cases those indi-
viduals who have no detectable exposure are included in the lowest dose
range.  The arbitrary assignment of unexposed workers to the lower end
of the distribution skews the data and would underestimate the overall
mean dose of those exposed.  To compensate for this bias, the midpoint
has been established as the mean.
     In addition to the assumption that all reported exposures are accu-
rate, it has been assumed that all overexposures were true individual
doses.  In only a limited number of cases was there any indication that
an investigation had been conducted following an overexposure or that any
adjustment in the individual's dose had been made.
     B.  Summary of Data from Reporting Agencies
     Below are discussed the data reported by Federal agencies and other
organizations.
          1.  Federal Agencies
     The reporting Federal Agencies include:  the Army, Air Force, Navy,
Atomic Energy Commission, and Public Health Service.
               a.  Army
     The Army employs approximately 22,790 individuals who may be exposed
to ionizing radiation as a result of their duties.  Sources to which Army
personnel may be exposed are quite varied.  Radiation protection practice
                                     136

-------
and control of sources is established by regulation and strictly en-
forced.  All exposure records are maintained at two processing centers
(Sacramento and Lexington Bluegrass Army Depots) which provided indi-
                                  2
vidual annual doses for this study.  For purposes of this evaluation,
individuals exposed as a result of employment to greater than 10 mrem/yr.
                                                                    3
have been considered to be radiation workers.   It has been suggested
that individuals receiving an annual dose of less than 10 mrem should
                 ii                                 , 3
be considered as  occasionally exposed individuals."
     The method of reporting exposure data was  such that the broad cat-
egories of occupational specialities could be identified as medical, in-
dustrial, and reactor fields.
     As shown in Table IV-1 the average dose per worker (>10 mrem/yr.)
in the medical field is 95 mrem, industrial field 94 mrem, and the reactor
field, 245 mrem.
                               Table IV-1
         Summary of Army Annual Occupational Doses - 1969 to 1970
Job Category
All
Medical
Industrial
Reactor
Percent of
Workers
100
49.6
46.5
3.8
Percent in Dose Range (rem) Mean
0-0.1 0.1-0.5 0.5-1.5 >1.5 (mrem)
96 3.2 0.68 0.02 100
95
94
- - - 245
     Included in the data provided by the film badge processing facilities
is dose information from other Government agencies, such as the National
Bureau of Standards and from some National Aeronautics and Space Admin-
istration facilities.
               b.  Air Force
     The Air Force monitors 34,975 individuals who may be exposed to ion-
izing radiation in the course of their work.  The Radiological Health Lab-
oratory at Wright-Patterson AFB provides dosimetry service and serves as
a repository for exposure data for the Air Force.  All doses for this
study were provided by that agency through the Surgeon General,  Depart-
                     4
ment of the Air Force.

                                      137

-------
     The system developed by the Air Force not only records Individual

doses but categorizes them in terms of dose groups for a specific occu-
                  c c
pational specialty.'   Table IV-2 shows the mean annual dose for selected

occupational areas.  Through discussions with personnel at the Radiolog-

ical Health Laboratory, it was determined that anyone having a recorded

dose less than 10 mrem/yr. was included in the 10 to 49 mrem range.  An

estimate of the number of these individuals was deducted from total mon-

itored personnel prior to determining the mean dose in each job cate-

gory.  The calculated mean annual dose for Air Force occupational ex-

posure is 88 mrem.


                               Table IV-2
Summary of Air
Force Occupational Doses
- 1969 to 1970

Job Category
Medical X-ray
Dental X-ray
Veterinary X-ray
Medical nuclide
Industrial nuclide
Industrial X-ray
Radar
Special weapons
Reactors
Miscellaneous
TOTAL


0-0.049 .049-. 099 .1-
95.7 2.4 0
Percent of
Workers
23
19
1
3
19
12
8
4
1
10
100
Percent of Workers
Dose Range (rem/yr.)
.299 .3-. 499 .5-1.49 1
.9 0.6 0.3
Mean Annual Dose
(mrem)
101
77
67
100
68
79
67
89
461
98
88


.5-2.99 3-4.99 >5
0.05 0.02 0.02
               c.   Navy

     Occupational exposure data for the Navy are maintained by  the Naval

Medical Data Services Center, Bethesda, Maryland.  Exposure data on 55,051

individuals was provided for this study through the Radiation Safety Office

National Naval Medical Center  (see Table IV-3).
                                   138

-------
                               Table IV-3
            Summary of Navy Occupational Doses - 1969 to 1970
Job Category
Medical
Industrial
TOTAL
d. Atomic
Percent of Workers
10
90
100
Energy Commission
Mean Annual
(mrem)
83
211
198

Dose




     The Atomic Energy Commission maintains dosimetry records for employ-
ees and contractors who routinely work with byproduct material and special
nuclear material.  The 1969 data used for this study included exposures
to 102,918 employees.  The format was in dose ranges of 1 rem from 0 to
12 rem?'9
     To determine the total man-rem, the low range of 0 to 1 rem was
divided into smaller increments corresponding to those reported for Atomic
Energy Commission and agreement State licensees.  The percentage of employ-
ees assigned to each range was assumed to be comparable to licensees.  The
reported ranges and the estimated ranges are shown in Table IV-4.  The
total man-rem was calculated to be 20,361.  This results in an overall
mean annual dose of 198 mrem per worker.
               e.  Public Health Service
     The Public Health Service provides dosimetry for all its activities,
as well as for the Bureau of Prisons and the Coast Guard.  The sources
of exposure in these agencies are similar to those found in the practice
of medicine and dentistry throughout the United States.
     A thorough analysis of the results of this dosimetry program was
furnished for this study.   During fiscal year 1970, film badge records
were maintained for 2,750 individuals.  Of this number, 508 exceed 10
mrem.  For this group the mean annual dose was 129 mrem.
               f,  Other Federal Agencies
     It has been estimated that approximately 2,000 Federal employees
may not have been included in the reports of other agencies.  To account
for these employees, they have been assigned the mean dose for the Public
Health Service.

                                    139

-------
                              Table IV-4
•y of Atomic Energy
Commission* Occupational Doses -

Dose Range
(rem/yr . )
0-1
(0-0.1)
(0.1-0.2)
(0.2-0.5)
(0.5-1.0)
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
10-11
11-12
>12
TOTAL
Number of Percent of
Persons Total
98,625 95.8
(73,372) (71.3)
(9,869) (9.6)
(10,059) (9.8)
(5,325) (5.2)
2,554 2.5
1,313 1.3
335 0.3
86 0.1
4
0
0
0
0
1
0
0
102,918 100
          ^Contractors and employees.
          2.  Nonfederal Activities
     Nonfederal activities include Atomic Energy Commission licensees,
agreement State licensees, X-ray use in the healing arts, and medical
use of radium.
               a.  Atomic Energy Commission Licensees
     Atomic Energy Commission regulations require that certain categories
of licensees report annually all doses in excess of 1.25 reins.  Admin-
istratively, many licensees find it easier to report all doses.   Data
are also obtained as part of an annual survey of exposure levels determined
by commercial film badge suppliers.  The data provided by this survey
represent approximately 29% of the total number of Atomic Energy Com-
                                   140

-------
mission licensees.  Of the 62,090 individual records, 95.8% indicated
                         12
a dose of less than 1 rem.   The employees for whom records were pro-
vided are estimated to be approximately 40% of all occupationally ex-
                                                                   Q
posed personnel operating under an Atomic Energy Commission license.
     All doses were reported in ranges as shown in Table IV-5.  The
total man-rem and mean dose values were calculated as previously de-
scribed and are shown in Table IV-6.  It is believed that they are over-
                              Table IV-5
     Summary of Reporting Atomic Energy Commission  (AEC) Licensee
and Agreement State Licensee Occupational Doses -


Dose Range
(rem/yr . )
0
0
0
0






.0-0.1
.1-0.2
.2-0.5
.5-1.0
1-2
2-3
3-4
4-5
5-6
>6
TOTAL


Numbe r


1969


(and %) of Persons
AEC Licensee
45,785
5,224
5,777
2,710
1,489
583
191
109
64
158
62,090
(73
(8
(9
(4
(2
(0
(0
(0
(0
(0
.7)
.4)
.3)
.4)
.4)
.9)
.3)
.2)
.1)
.2)
(100)
State Licensee
17,041
2,084
2,550
1,422
785
319
98
73
49
98
24,519
(69
(8
(10
(5
(3
(1
(0
(0
(0
(0
.5)
.5)
.4)
.8)
.2)
.3)
.4)
.3)
.2)
.4)
(100)
estimates of the actual  individual  dose  to  all employees because it is
assumed that the 60% not reported were below  1.25 rem/yr.  Thus, approx-
imately 93,000  individuals  are exposed to some level of radiation less
than the mean annual exposure of those who  may be expected to exceed
1.25 rem.  Since the opportunity for exposure of the higher group would
be up to 5 rem/yr., and  the opportunity  for exposure of the lower group
is 1.25 rem/yr., a simple ratio of  opportunity to be exposed has been
used to calculate the mean  of 54 mrem for the lower group.  These doses
are shown as nonreported Atomic Energy Commission licensees in  summary
tables below.
                                    141

-------
                              Table IV-6
                Mean Annual Doses for Reporting Atomic
                  Energy Commission Licensees - 1969
Activity
Medical
Major processor
Waste disposal
Radiography
Industrial
Academic
Reactors
Fuel processing
Packing and
transport
Not specified
TOTAL
b.
Employees
20,228
1,789
21
1,894
13,331
7,738
2,302
6,637
335
7,815
62,090
Agreement State
Man-rem
5,260
495
96
752
2,139
903
497
2,177
22
1,024
13,365
Licensees
Mean Dose
(mrem)
260
276
457
397
160
117
216
328
66
131
215

     During 1969 there were 17 (22 at the end of 1970) States which had
assumed regulatory authority over byproduct, source, and limited quan-
tities of special nuclear materials.  These agreement States continue to
cooperate with the Atomic Energy Commission to insure compatible regu-
latory programs.
     Exposure data for 1970 comparable to that of Atomic Energy Commission
licensees were provided for this study through the Atomic Energy Commis-
                                  Q
sion by 15 of the agreement States  (see Table IV-5).  Since only 15 of
the 17 agreement States were reported, an average of the reporting States
was used to add 3,000 employees for the two States which did not report.
The mean dose of the reporting States (Table IV-7) was used to determine
man-rem as shown under nonreporting States in summary tables below.
               c.  X-ray Use in the Healing Arts
     The most tenuous estimate developed in this study is the mean annual
dose of nonfederal employees exposed during the use of radiation in
diagnostic and therapeutic medical and dental radiology.  The data for

                                   142

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                              Table IV-7
Mean Annual Occupational Doses for Agreement
State Licensees - 1970

Activity
Medical
Processor
Waste disposal
Radiography
Industrial
Academic
Not specified
TOTAL

Employees
11,867
32
256
1,174
6,479
3,980
731
24,519

Man-rem
3,403
37
766
294
1,490
499
226
6,715

Mean Dose
(mrem)
286
1,160
2,991
250
230
125
309
273
estimating this value has been obtained from a limited number of State

health organizations which maintain central files on occupational doses

and those which have conducted film badge surveys.

                    (1)  Wisconsin

     The State of Wisconsin has conducted film badge surveys on various

categories of radiation workers for limited periods of time to evaluate

the radiation protection procedures being followed by persons using x rays

in the healing arts.

     The most recent survey conducted involved 4,175 dentists for 1 month.
                                         13
The data obtained are shown in Table IV-8.   The mean annual dose was

calculated to be 156 rarem.

                               Table IV-8

             Wisconsin Dental Facility Survey - 1969 to 1970


      Number                Percentage in Dose Rate Range (mrem/week)
     Surveyed	0 - 1Q	11 - 50	50 - 99	>100

      4,175                93.6         5.8         0.6          0*
Assumed mean
Number
Total man-mrem/wk.
1
3,908
3,908
30
242
7,260
75
25
1,875
140
0
0
     *Originally 4 individuals;  review indicated improper handling of
      badge.   Resurvey of these placed them in a lower range.

                                   143

-------
     During 1969 a survey of 663 medical x-ray workers indicated an
                                              14
average total dose rate of 4,150 man-mrem/week.    Assuming that each
individual works for 50 weeks/yr. the mean annual dose would be 313
mrem.
                    (2)  Illinois
     The State of Illinois requires that reports of all occupational
exposure of employees who may receive a dose of greater than 0.312 rem/
quarter be submitted to the Department of Public Health.  The data for
a portion of 1970 is shown in Table IV-9.   Although this program has
been operating since 1964,  it was not until 1970 that investigations of
                              Table IV-9
Summary of
Illinois Whole-body
Radiation Doses
- 1970

Category
Dentists
Physicians
Osteopaths
Chiropractor
Veterinarians
Podiatrists
Nursing institution
Hospitals
Clinics
Private laboratories
Number of
Reports
24
75
0
10
6
0
3
1,125
45
3
Mean Dose
(rem/quarter)
0.024
0.043
0
0.003
0.098
0
0.023
0.085
0.080
0.057
Man-rem/
Quarter
0.58
3.22
0
0.03
0.59
0
0.069
95.6
3.6
0.17
reported overexposures were required.  It is believed that the reported
data for 1970 represent a more valid mean dose than that of previous years
when no attempt was made to determine if a badge exposure represented the
exposure of the worker.
     The data in Table IV-9 yield a dose of 324 mrem to these medical
workers and 96 mrem to the dental workers.
                    (3)  Maine
     The State of Maine operated a statewide film badge service from 1956
to 1968.  During the period 1956 to 1965, 580 individuals representing
                                    144

-------
about 75% of all radiation workers in the State were monitored by this
program.  During fiscal year 1965, the average dose per month for all
                                 16
                    •s was 20 mrem.
                     (4)  National Mean Dose
categories of workers was 20 mrem.
     The data from the foregoing three States are the only readily avail-
able bases for establishing a national mean annual dose of 320 mrem per
nonfederal medical x-ray worker and 125 mrem per nonfederal dental x-ray
worker.  These means are applied to the 194,541 medical x-ray worke-s
                                                     17
and 171,226 dental x-ray workers in the United States.
               d.  Medical Use of Radium
     A survey of personnel occupationally exposed in radium therapy was
conducted by the State of Wisconsin.  The results of this study provided
to the Public Health Service indicated that there may be as many as 185
medical radium workers per million population.  Extending this to the
population of the United States would indicate that there may be up to
37,925 individuals occupationally exposed in radium treatment who are
not otherwise reported.  The estimated number of radium treatments in
Wisconsin is 800 per year.  From 37 treatments monitored, the average
total dose was 500 mrem per treatment or 400 man-rem per year from all
treatments.  This results in a mean annual dose of 540 mrem for the 740
medical workers in Wisconsin.  This mean has been applied as a national
mean dose from medical use of radium.
          3.  Summary
     A summary of man-rem by reporting agency and occupation is shown in
Table  IV-10.
     C.  Internal Doses Incident to Occupation
     It has been reported that reactor and accelerator workers as well as
those  involved with the manufacture and use of unsealed radioactive
material can accumulate detectable amounts of radioactive material in
                                    18
the whole body and in various organs.
     In two studies, 91 radiopharmaceutical production workers and medical
and paramedical personnel were subjected to whole-body counting over a
                1 Q or\
period of 1 year.  '    Of the individuals monitored, approximately 88%
                                    145

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Table IV-10
Total Annual Whole-body Man-rem by Reporting Group and Occupation - 1969 to 1970

Activity
Healing arts
Medical x ray
Dental x ray
Radionuclides
Veterinary x- ray
Medical radium
Industrial practice
Radionuclides
Radiography
Reactors
Waste disposal
Fuel processing
Packaging & transport
Radar
Special weapons
Academic
Not specified
Major processing
Air
Force
736
(405)
(264)
(53)
(14)
394
(229)
(165)
100



96
65

164

State
Army Navy Licensee
366 477 3,403

269 10,402 1,784
(1,490)
(294)
73
766




499
226
37
AEC Non- Nonreporting Licensee
Licensee AEC PHS federal State AEC
5,260 65 104,136
(62,253)
(21,403)
(20,480)
2, 891
(2,139)
(752)
497
96
2,177
22


903
1,024 20,361 819 5,022
495

-------
had detectable body burdens although the average body burden was a
very small percentage of the maximum permissible body burden  (1.3%  for
radiopharmaceutical workers).  None of the  individuals  in these studies
had more than 15% of a maximum permissible  body burden.  During the
study of radiopharmaceutical workers up to  19 nuclides  were identified
while nine nuclides were found in the medical and paramedical personnel.
     Because of the sparsity of data and difficulty  in  determining  the
contribution of internal emitters to population dose it  is not included
in estimates of population dose.
     D.  Population Dose from Occupational  Exposure
     Using reported numbers of workers and  judicious estimates in non-
reported areas, a value for the number of workers in the population was
derived.  As shown in Table IV-11, this number is 771,814 or 3.76 per
thousand population.
     As shown in Table IV-11, the total man-rem from occupational ex-
posure is 163,922; mean annual dose is 210  mrem/worker.  The percentage
of employees in dose ranges by agency are shown in Table IV-12.  For
the population of the United States, assuming the dose  indicated by
dosimetry to be a whole-body dose, the calculated whole-body dose is
0.8 mrem per capita.
     E.  Population Dose from Occupational  Exposure,1960 to 1970
     The evaluation of occupational dose during the  period 1960 to 1970
is complicated by a lack of appropriate monitoring data.  In many cases,
the personnel monitoring systems of various agencies were relatively new
or nonexistent in 1960.  In addition, the reliability of dosimetry data
was more questionable than it currently is  and the appropriate persons
to be monitored were doubtful.
     For many agencies the early 1960's marked the beginning of active
radiation protection programs and serious efforts to reduce dose to the
lowest practicable level were introduced.
     From the data available,it may be reasonably concluded that the
average dose per worker was reduced during  this period.  In general, the
percentage of workers in the range from 0 to 1 rem increased and the
total number of doses in excess of 5 rem/yr, decreased.  In 1960,it was
                                    147

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                                Table IV-11


         Total Annual Occupational Whole-body Doses - 1969 to 1970


Agency
Army
Air Force
Navy
AEC
PHS
Other Federal
AEC licensees
Agreement State
Nonfederal
medical x ray
Nonfederal
dental x ray
Medical radium
Nonreporting
AEC licensees
Nonreport ing
agreement State
TOTAL

Number of
Workers
7,445
17,591
55,051
102,918
508
2,000
62,090
24,519

194,451

171,226
37,925

93,000

3,000
771,814


Man-rem
744
1,555
10,879
20,361
65
258
13,365
6,715

62,253

21,403
20,480

5,022

822
163,922
Mean Dose
per Worker
(mrem)
100
88
198
198
129
129
215
274

320

125
540

54

274
210
Average Dose to
U.S. Population
(mrem)
0.003
0.007
0.05
0.10
0.0003
0.001
0.07
0.03

0.30

0.10
0.10

0.02

0.004
0.8
reported that at two major Atomic Energy Commission facilities, Oak Ridge


National Laboratory and Hanford facilities,  the annual average exposure of

                                                   21
radiation workers was 0.4 R and 0.2 R,  respectively.   For these reasons


an annual average dose of 300 mrem/worker has been used for 1960.


     The numbers of workers in the population in 1960 are also obscured


by lack of reliable records.  To determine the number of medical workers


(excluding dental) an annual rate of increase in demand for service of

                  22
7.1% has been used.   Extrapolating from 1970 data, shown in Table IV-13,


the number of medical radiation workers per thousand population would be


0.88 or 161,000 workers.


     For dental workers, although the ratio of dentists to the population


has decreased below the 1950 ratio, the ratio of allied workers has in-
                                     148

-------
                               Table IV-12

        Percent of Employees in Annual Dose Ranges - 1969 to 1970
Reporting
Agency
AEC
State
1 icensees
AEC
licensees
Army
Air Force
PHS
Navy
Number of Dose Ranges (rem)
Employees 0-1 1-2 2-3 3-4
102,918 95.8 2.5 1.3 0.3
24,519 96.2 3.2 1.3 0.4
62,090 95.8 2.3 0.9 0.3
22,790 99.0 - - 1.0
(7,445)°
34,975 99.0 - - 1.0
(17,591)°
508 99.0 - - 1.0
55,051 Not available
4-5 >5
0.1 0.0
0.2 0.6
0.1 0.3
-
-
-

a!5 of 17.
b~40%.
cNo.  >10 mrem/yr.
                               Table IV-13
Job Category Data - 1969 to 1970

Category
Medical x ray
Dental x ray
Medical radio-
nuclides
Medical radium

Number
of Workers
(thousands)
203.6
178.6
33.5
38.0

Workers/
Thousand
0.99
0.87
0.16
0.18

Annual
Man -rem
(thousands)
63
22
8.8
20

Average Dose to
U.S. Population
(mrem/yr . )
0.3
0.1
0.04
0.1
Research and
  industrial use
318.3
1 .55
                        49
                           0.2
                                    149

-------
       23
creased   and the ratio of radiation'workers is believed to be relatively
constant from 1960 to 1970.  For this reason the value of 0.87 workers
per thousand or 159,000 workers has been used for dental practice.
     There was undoubtedly a significant change in the numbers of radi-
ation workers involved in industrial applications from 1960 to 1970.
The advent of a nuclear-powered naval force during this period increased
the number of workers by several thousand.  It was also reported in 1960
that the Atomic Energy Commission classified 66,000 employees as radi-
             21                                     '
ation workers.   It has been assumed that the workers per thousand in
this area did not exceed 0.75,  or 137,000 workers.
     The total radiation workers as derived above is 457,000 and repre-
sents 0.25% of the 1960 population as opposed to 0.2% reported by the
                                      21
Federal Radiation Council in that year.   Using this number of workers
and a mean annual dose of 300 mrem/worker, the resulting population
dose is 0.8 mrem per capita (Table IV-14).
                              Table IV-14
Estimated Annual Whole-body Doses to the United
States
1 Population from Occupational Exposure
(mrem)
Practice
Medical
Dental
Industrial
TOTAL

1960
0.3
0.3
0.2
0.8

1970
0.4
0.1
0.3
0.8
Year
1980
0.4;
0.1
0.3
0.8

1 1990
0.4
0.1
0.4
0.9

2000
0.3
0.1
0.5
0.9
     F.  Population Dose from Occupational Exposure,1980 to 2000
     To estimate the population dose through the year 2000,the following
assumptions have been used.
     1.  The number of workers in dental practice will remain constant
at 0.87 per thousand.
     2.  The demand for medical care will increase at a lesser rate until
it becomes constant at 1.5 per thousand in 1990.  The value for 1980 has
been assumed to be 1.3 per thousand.
                                   150

-------
     3.  The greatest increase will be from industrial usage, partic-
ularly from the increase in nuclear power facilities and the required
ancillary support activities.  The number of workers in this category
will increase continually through the period under consideration.  The
number of workers per thousand estimated for 1980, 1990, and 2000 are
1.7, 2.0, and 2.2, respectively.
     4.  Through legislation and education, the practice of good radi-
ation protection methods will become more widespread among the users of
ionizing radiation.  Without consideration of development of new tech-
niques, the enforcement of currently recognized good practice will sub-
stantially reduce tr^e mean annual dose per worker.  By the year 2000, the
mean for medical workers should approach the current mean for Federal em-
ployees.  It is assumed that this will be for 1980, 1990, and 2000:  300
mrem, 250 mrem, and 200 mrem, respectively.  A similar reduction in oc-
cupational exposure from dental practice is assumed to result in mean
annual doses of 110 mrem, 100 mrem, and 95 mrem, respectively.
     5.  In industrial and research activities the mean annual dose will
probably increase.  Although the more widespread use of good protection
methods will lessen the impact, it is anticipated that the mean annual
doses from these sources will approach 225 mrem by the year 2000.  For
1980 and 1990, 175 mrem and 200 mrem have been used as the mean.
     The foregoing assumptions have been used to estimate the future pop-
ulation doses shown in Table IV-14.
                                    151

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                               REFERENCES

 1.  United Nations.   1972.   Report of the United Nations Scientific
     Committee on the Effects of Atomic Radiation.  New York.  (In
     preparation.)

 2.  Army.  1971.  Summary of individual exposures to ionizing radiation,
     1966-1970.  Lexington Bluegrass Army Depot,  Lexington,  Kentucky.
     (Unpublished data.)

 3.  National Council on  Radiation Protection and Measurements.  1971.
     Basic radiation  protection criteria, report  No. 39.  Washington.
     ix,  135 pp.

 4.  Air  Force.  1971. Occupational radiation exposure history of United
     States Air Force personnel.  Radiological Healtii Laboratory, Wright-
     Patterson AFB, Ohio.  (Unpublished data.)

 5.  Air  Force.  1968. Supplemental instructions for the film badge
     dosimetry program.   Radiological Health Laboratory, Wright-Patterson
     AFB, Ohio.

 6.  Air  Force.  1965. Film badge dosimetry program.  Washington, AFR
     161-11.

 7.  Navy.  1971.  Summary of exposures to ionizing radiation in the U.S.
     Navy.  Naval Medical Data Services Center, Bethesda, Maryland.
     (Unpublished data.)

 8.  Denton, L.D.  1971.   Personal communication.  Division of Compliance,
     U.S. Atomic Energy Commission, Washington.

 9.  Atomic Energy Commission.  1961-1971.  A summary of industrial
     accidents in USAEC facilities.  U.S. AEC report TID-5360.  var. pp.

10.  Pettigrew, G.L.   1971.   A review of the Public Health Service film
     badge program.    (Unpublished.)

11.  Atomic Energy Commission.  1971.  Personal communication.  Assistant
     for  Workmen's Compensation and Radiation Records, Office of the
     Assistant General Manager for Operations, Washington.

12.  Atomic Energy Commission.  1971.  pp. 96-98.  In:  Annual report to
     Congress of the  Atomic  Energy Commission for 1970.  Washington.

13.  Wisconsin Department of Health.  1971.  Personal communication.

14.  Pettigrew, G.L.   1970.   Memorandum to the Director, Bureau of Radio-
     logical Health,  Public Health Service, Washington.
                                    If) 2

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15•   Illinois Department of Public Health.  1971.  Summary of whole-body
     exposure reports.  Springfield, Illinois.   (Unpublished data.)

16.   Puller, J.W.  1966.  Maine's experience with a State-operated
     personnel monitoring program for radiation workers.  Radiological
     Health Data 7:  489-492.

17-   Fess, L.R.  1969.  Summary of diagnostic X-ray statistics relating
     facilities, equipment and personnel by healing arts professions.
     Radiological Health Data 10:  379-380.

18.   Sill, C.W., J.I. Anderson and D.R. Percival.  1964.  Comparison of
     excretion analysis with whole-body counting for assessment of inter-
     nal radioactive contaminants,  pp. 217-228.  In:  Assessment of
     Radioactivity ±n_ Man.  International Atomic Energy Agency, Vienna.
     Vol. I.  (STI/PUB/84.)

19.   Athey, T.W., C. Killian, M.A. Dugan and B.  Shleien.  1970.  Whole-
     body counting of some radioactive isotope and radiopharmaceutical
     production workers.  Am. Industr. Hyg. Assoc. J. 31:  711-717.

20.   Shleien, B. and E. LeCroy, Jr.  1971.  Results of thyroid and whole-
     body counting of some medical and paramedical personnel.  J. Nucl.
     Med. 12(7):  523-525.

21.   Federal Radiation Council.  1960.  Background material for the
     development of radiation protection standards, staff report.  Wash-
     ington, report No. 1.  iii, 39 pp.

22.   Public Health Service.  1966.  Protecting and improving health
     through the radiological sciences.  National Advisory Committee on
     Radiation, Washington.  vi, 27 pp.

23.  Public Health Service.  1969.  Health resources statistics, 1969.
     Washington, Publ. No. 1509.  vi, 286 pp.
                                    153

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V.  MISCELLANEOUS RADIATION

-------
                      V.  MISCELLANEOUS RADIATION
     There are several sources of exposure to ionizing radiation to which
the general public may be exposed that are not discussed in the previous
sections of this report.
     A.  Television Receivers
     In 1968 a survey of 1,124 color television receivers was performed
in the metropolitan Washington, D.C., area.  The average rate of emission
of ionizing radiation 5 cm from the front face of these receivers was
found to be 0.043 mR/hr.  This survey also analyzed the viewing habits
of the family members in the households where receivers were surveyed.
     Based on the 1968 survey, estimates of potential doses to various
organs were derived.  For purposes of this report, the female gonadal dose
has been selected to represent the somatic dose for determination of total
man-rem from this source.
     To determine the total man-rem and mean per capita dose as shown in
Table V-l, the following assumptions have been made.
          1.  The viewing habits of the population are essentially the
same as those in the 1968 survey and will not change.
          2.  The population exposed in 1970 is approximately 50% of the
total population.  This  is based on 24% of the households having color
                  3                                       2
television in 1968  and  39% in 1969, and a production rate  of 500,000
color television receivers per month.
          3.  The population exposed in 1980 will approach 100%.
          4.  The trend  in reduction of emission rate from television
receivers noted in 1968  and 1969 will continue with improved design  and
                O
new developments.  A reduction of average emission rate to 0.025 mR/hr.
at 5 cm by 1980 is assumed.  Since the estimates of dose mentioned above
are based on  a linear function of exposure rate a proportional reduction
                   2
in dose is expected.
                                    157

-------
     The estimates are shown in Table V-l.   These may be high by as much
                                                                       2,3
as a factor of two because of instrument calibration in the 1968 survey.

                               Table V-l

                 Total Annual Average Whole-body Doses
from Television Receivers -

Year
Emission rate (mR/hr . at 5 cm)
Mean dose (mrem)
Age <1 5 yr .
Age >15 yr.
Population at risk (millions)
Age <15 yr.
Age >15 yr.
Man-rem 26
Total population (millions)
Mean per capita dose (mrem)
B. Consumer Products Containing

1970
0.043

0.4
0.2

28
75
,200
205
0.1
1970 to 2000

1980
0.025

0.2
0.1

63
174
30,000 35
237
0.1


1990
0.025

0.2
0.1

80
197
,700
277
0.1


2000
0.025

0.2
0.1

89
232
41,000
321
0.1
Radioactive Material
     For many years,radium has been used in items readily available to

the general public.  Some of these uses are:  fire detection devices,

static eliminators, gauges, electronic tubes, and laboratory balances.

In many instances the user is unaware that radium is incorporated into
                                                       4 5
the product or that a potential radiation hazard exists.'   In recent
                  147
years,tritium and    Pm have also been used as radiation sources in

self-luminous devices.  Luminous watches appear to be the greatest source

of population exposure from the devices mentioned above.

     The number of watches containing radioactive materials is difficult

to estimate.  In the case of watches containing radium,  no United States

data are available.  However, assuming usage similar to that in foreign
         4
countries  as much as 35 to 50% of the adult United States population may

have possessed a watch containing radium in the late 1960's.  Tritium

compounds imported into the United States together with domestic manu-

facture indicate that 25 million watches containing 1 to 5 mCi of tritium
                                                /?
were sold during the year June 1969 to June 1970.  During this same period


                                    158

-------
                                                     147
approximately 1 million watches with 30 to 50 (iCi of    Pm were made
available to the public.
     Doses from radium watches reported in 1963 appear to indicate whole-
                                      7
body doses between 1.3 and 5,3 mrem/yr.  Whole-body doses from 1 to 4
mrem/yr. have been estimated, using a quality factor of 1.7, in persons
using wrist watches containing tritium,'   while watches containing    Pm
                            g
give doses in the p,rem range.
     Other luminescent items containing radioactivity, particularly self-
luminous military devices, make slight contributions to the total popu-
lation dose,  the maximum estimated to be 0.01 mrem/person/yr. to the
United States population.
     The estimated annual whole-body dose to the population of the United
States in 1960 is 1 mrem, and for 1970, 1.5 mrem.  The projected average
for 1980 is 1 mrem and 0.01 mrem for 1990 and 2000.  These estimates re-
flect increased use of radium and tritium in watches from 1960 to 1970
                     147
and increased use of    Pm from 1970 to 2000.
     C.  Air Transport
     Passengers and crew of aircraft are subjected to increased rates of
exposure during high altitude flight from galactic cosmic radiation.  Pre-
             9
liminary data  show that the average increase in dose equivalent rate at
an altitude of 30,000 ft. (approximate conventional jet aircraft altitude)
may be 0.7 mrem/hr. and at 60,000 ft.  (supersonic transport aircraft
altitude) 1.1 mrem/hr.
     There were 125 billion passenger-miles flown by United States air-
lines during 1970.   It is estimated that the average air speed during
this period was 400 mi./hr.  (average in 1968 was 389 mi./hr.).   Using
these values, 310 million passenger-hours were flown by United States
airlines during 1970.  It is assumed that all flights were at conventional
jet altitude.
     As a result of air transport, approximately 200,000 man-rem were
accumulated by passengers.
     Air crew members are considered here as a special occupational group.
The number of air crew members has not been obtained.  However, the total
number   of aircraft owned and leased by air carriers in 1969 was 2,638,
                                    159

-------
Assuming an average crew of five, there could be up to 13,000 air crew
members employed.  To include military air crews, it is estimated that
there are approximately 15,000 individuals serving as air crew members
operating at conventional jet altitudes.
                                                  10
     Using a value of 80 hr.  flight time per month,  the average crew
member receives a dose of 670 mrem/yr.
     From high altitude flight, the population dose is estimated to be
210,000 man-rem during 1970 or a mean United States per capita dose of
1.0 mrem.
     For projected doses from air transport, super-sonic altitudes must
be considered.   It is indicated that the dose to passengers will be re-
duced because of the shorter time at altitude even though the dose rate
is increased.  No assumptions on projected air crew dose have been made.
Because  the conditions of air transport are in doubt, the projected doses
are proportional to population increase only.
     The foregoing estimates are based on limited studies which should
be re-evaluated  as more data become available.
     D.  Summary
     The total estimated annual whole-body doses from miscellaneous sources
to the United States population are summarized in Table V-2.
                                Table V-2
Total Annual Average Whole-body
Doses
to the
United States Population
from Miscellaneous Sources














Doses
Television
Year
1960
1970
1980
1990
2000
mrein
0
0.1
0.1
0.1
0.1
man-rem

26,
30,
36,
41,
0
000
000
000
000
Consumer Products
mrem
1
1
1
0
0
.0
.5
.0
.01
.01
man-rem
180
310
240
3
3
,000
,000
,000
,000
,000
Air Transport
mrem
1
1
1
1
1
.0
.0
.0
.0
.0
man-rem
180
210
240
280
320
,000
,000
,000
,000
,000
Total
mrem
2.0
2.6
2.1
1.1
1.1
man-rem
360,000
550,000
510,000
320,000
360,000
                                    160

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                               REFERENCES

 1.  Public Health Service.  1968.  A survey of X-radiation from color
     television sets in the Washington,  D.C. metropolitan area.  Bureau
     of Radiological Health TSB report No.  3.   21 pp.

 2.  Neill, R.H.,  H.B.  Youmans and J.L.  Wyatt.  1971.  Estimates of
     potential doses to various organs from X-radiation emissions from
     color television picture tubes.  Radiological Health Data 12;  1-5.

 3.  Electronic Industries Association.   1971.  Evaluation of television
     contribution  to the annual genetically significant radiation dose of
     the population.  Radiological Health Data 12:  363-369.

 4.  Robinson, E.G.   1968.  The use of radium in consumer products.  U.S.
     Public Health Service report MORP 68-5.  vii, 25 pp.

 5.  Department of the  Army.  1966.  Ionizing radiation facilities,
     Annlston Army Depot.  Radiation Protection Survey No. 4948R97-65/67.
     U.S. Army Environmental Hygiene Agency, Edgewood Arsenal, Maryland.
     23 pp.

 6.  Barker,  R.  1971.   Personal communication.  Division of Radiological
     and Environmental  Protection, U.S.  Atomic Energy Commission, Washing-
     ton .

 7.  Schell,  W.R.  and B.R. Payne.  A possible contamination source in low
     level tritium laboratories.  Intern. J. Appl. Radiation Isotopes
     22(11):   653-656.

 8.  Moghissi, A.A.   1971.  Personal communication.  Western Environmental
     Research Laboratory, Environmental  Protection Agency, Las Vegas,
     Nevada.

 9.  Federal  Aviation Administration.  1970.  Interim report on the radi-
     ation biology aspects of the supersonic transport.  Advisory Committee,
     Washington.  35 pp.

10.  Gerathewohl,  S.J.   1971.  Personal  communication.  Federal Aviation
     Administration, Washington.

11.  Federal  Aviation Administration.  1970.  Handbook of airline statistics
     Civil Aeronautics  Board, Washington.  ix, 544 pp.
                                    161

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VI . SUMMARY

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                             VI.  SUMMARY

     The study reported in this document is that part of the overall re-

view of the bases for radiation guidance that is concerned with estimates

and predictions of ionizing radiation doses in the United States from all

sources.  Estimates or predictions were made for each decade of the peri-

od 1960 to 2000.  The results are presented in Table VI-1 and Figures

VI-1 and VI-2 and are summarized below?  It should be noted that in this

summary more digits are shown than are actually significant in order to

indicate trends.  A number of sources were found to contribute insignifi-
cantly to the total annual dose to the United States population.  The

sum of the doses contributed by these sources is also insignificant.
     A.  Environmental Radiation
     A major source of radiation doses in the United States is natural

radiation.  The total estimated annual whole-body dose increases from 23.8
million man-rem in 1960 to 41.7 million man-rem in the year 2000 from
cosmic and natural terrestrial sources.  The increase is due exclusively
to increases in population size.  Global fallout from nuclear explosives

tests contributed about 1 million man-rem (whole-body) in 1960, a high of

2.4 million man-rem in 1963, and 0.8 million man-rem in 1970.  Future

doses from fallout for 1980 are predicted to be 1.1 million man-rem, in-

creasing to 1.6 million man-rem in 2000, the increase again being due to

population growth.  The total dose contributed by all other environmental

sources increases from 0.015 million man-rem in 1960 to 0.15 million man-

rem in 2000.

     B.  Medical Radiation
     By far the greatest portion of the man-made radiation dose to  the

United States population is due to exposure accrued during medical  diagnostic

Comparisons based on whole-body doses except for doses from medical radi-
 ation, in which case the abdominal dose, an index of somatic dose, is used.
                                    165

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10O —
  10-
c
o
   1 —
I


C
  0.1-
 0.01,
                                              Total



                                              Natural

                                              Medical
                                              Global Fallout
                                              Miscellaneous
                                              Occupational


                                              Other

                                               Environmental
   196O
197O
1980


Year
199O
2OOO
       Figure VI-1.  Summary of Estimated Whole-body Radiation Man-rem

       Doses in the United States
                                  166

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 100-
                                 Total



                                 Natural

                                 Medical
  10-
c
o
If)
1_
a;
a
\

0)
    1-
                                 Global Fallout
                                 Miscellaneous

                                 Occupational

                                 Other
                                  Environmental
  0.1-
   1960
197O
1980

Year
1990
2OOO
          Figure VI-2.  Summary of Estimated Average Whole-body  Radiation

          Doses in the United States (mrem/person)
                                 167

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                               Table VI-1
              Summary of Whole-body Annual Radiation Doses
in the United States - 1960

Radiation Source
Environmental
Natural
Global fallout
All other
Subtotal
Medical
Diagnostic *
Radiopharmaceut icals
Subtotal
Occupational
Miscellaneous
TOTAL
Population (millions)
Per capita dose (mrem)
*Medical diagnostic man


1960
23.
1
0.
24.
13.
0.
13.
0.
0.
38.
183
211
8

015
8
2
07
3
14
36
6


-rem doses


Man -rem
1970
26.
0.
0.
27.
14.
0.
15.
0.
0.
43.
205
211
based
6
82
012
4
8
4
2
16
55
3


on

to 2000





(millions) for Years
1980 1990 2000
30
1
0
31
17
3
20
0
0
53
237
224
.8
.1
.022
.9
.1
.3
.4
.19
.51
.0


an index
36
1
0
37
19
4
23
0
0
61
277
224
.0
.3
.062
.4
.9

.9
.24
.32
.9


of somatic
41
1
0
43
23
5
28
0
0
72
321
225
.7
.6
.15
.4
.1

.1
.28
.36
.1


dose ,
the "abdominal dose."  For radiation therapy an annual per capita
genetically significant dose of approximately 5 mrem was estimated for
the year 1966,  but an index of somatic dose is not considered applicable.

procedures.  Medical diagnostic radiology accounts for at least 90 percent
of the total tuanmade radiation dose to which the United States population
is exposed.  This is at least 35% of the total radiation dose from all
sources (including natural radioactivity).   This comparison is based on
an interim index of somatic dose, the "abdominal dose," which was derived
from ovarian doses reported by the Public Health Service in 1964 and 1970.
The majority of this dose is accrued through medical diagnostic radiography
and fluoroscopy, with lesser doses accrued through the diagnostic uses of
radiopharmaceuticals and dental radiography.  Estimates indicate that the
annual per capita "abdominal dose" from these sources to the whole pop-
ulation, as estimated some time during the past decade, were 72 mrem, 1
mrem and less than 0.3 mrem respectively, from medical diagnostic radio-
                                   168

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graphy and fluoroscopy in 1970, the diagnostic uses of radiopharma-
ceuticals in 1966, and dental radiography in 1964.  It appears that
the mean abdominal dose for the U.S. population as determined in 1964
and 1970 has remained relatively stable during the two study years.  How-
ever, since the magnitude of the uncertainty surrounding the figures up-
on which the abdominal dose is based has not yet been determined, the
magnitude of whatever change may have occurred between 1964 and 1970
cannot be determined at this time.  The per capita dose to the exposed
population (i.e., persons receiving examinations) were, of course,
significantly higher than those to the whole population.  The estimated
total man-rem dose to the whole U.S. population in 1970 from the uses of
radiation in the healing arts is estimated to be 15.2 million man-rem
exclusive of occupational exposure and radiation therapy.
     The "genetically significant dose" is an index of radiation received
by the genetic pool.  Estimates of genetically significant doses indicate
values of 36 mrem (based on preliminary data from the 1970 U.S. Public
Health Service Survey) from medical and dental diagnostic radiation, 5
mrem from radiation therapy in 1966, and 0.3 mrem from the diagnostic
uses of radiopharmaceuticals (also in 1966).  Preliminary U.S. Public
Health Service information indicates a drop in genetically significant
dose in 1970 relative to the 1964 value of 55 mrem.  However,  as above,
since the degree of uncertainty of these values have not as yet been
determined, the magnitude of the change which may have occurred between
1964 and 1970 is not clear at this time.
     Projections of doses from diagnostic medical radiography must take
into consideration a variety of complex variables.  Review of several
reports on the rate of increase of radiographic examinations leads to the
conclusion that, in the past decade, the rate of radiographic examinations
increased between 1 and 4 percent per year.  Some of this increase appears
to be due to the expansion of radiological services to persons who pre-
viously did not have such care available.  Furthermore, there is some
evidence that technical improvements may be keeping pace with increasing
usage.  If this balance between increasing usage and technical improvement
is real,  and i±_ it continues,  the man-rem dose from diagnostic medical

                                    169

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radiation would increase through population increase alone to about 23.1
million man-rem by the year 2000.  Even before the year 2000, if the
current rate of increase in the uses of radiopharmaceuticals should
continue to 1980,  the whole-body man-rem dose from this source to the
U.S. population could be greater than 3.3 million man-rem, or approx-
imately 15% of that from other medical sources.
     The delivery of radiation for therapy is exluded in estimates of
accumulated man-rem doses to the population.   There is no significant
information to indicate the direction that the doses from radiation
therapy will take in the future even though its use might increase.
     Extrapolations and projections made in this study must be considered
in light of the uncertainties surrounding the base measurements, the
assumptions employed and the changing state of medical technology.  If
technical improvements can keep pace with increased usage rates, it can
be concluded, based on the information presently available and discussed
in this report, that the annual per capita population dose from diagnostic
medical radiography could remain stable.
     Finally, it should be noted that direct comparisons of medical x-ray
doses to the population with those from other sources is difficult because
x rays are administered purposefully to individuals at the discretion of
practitioners, and because they are delivered at higher dose rates to
limited areas of the body.
     C.  Occupational Radiation
     The contribution of occupational exposures to total United States per
capita dose is estimated to be less than 1 mrem/yr.  The major portion of
this dose during 1960 and 1970 was incurred through the use of ionizing
radiation in the practice of medicine and dentistry.
     Increased industrial use of ionizing radiation, particularly the pro-
jected increase in nuclear power production,  will  increase the per capita
dose by approximately 0.1 mrem/yr. by 1990.  During the 1990's the pop-
ulation dose from industrial sources and the practice of medicine and
dentistry will probably be about the same.  The total dose from occupa-
tional exposure to the United States population is estimated to have been
0.14 million man-rem in 1960 and is projected to reach 0.28 million man-
                                     170

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rem in the year 2000.



     D.   Miscellaneous Radiation



     Miscellaneous radiation  sources  (e.g.,  television,  consumer products,



and air transport) contribute to  the  radiation dose of the population of



the United States.   Estimated annual  average whole-body  doses to the pop-



ulation are 2.0 and  2.6  mrem  (0.36 million and 0.55 million man-rem) for



1960 and 1970, respectively.   Projected annual doses are 2.1 mrem (0.51



million man-rem)  for 1980  and 1.1 mrem (0.32 million and 0.36 million



man-rem) for  1990 and 2000.



     E.  Total Man-rem



     The total man-rem  to  the United  States population will increase in



the future due mainly to population growth.  It will approximately double



between 1970  and  2000,  43  million to  72 million man-rem, the population



increasing from 205  million  to 321 million.
                                    171
 c-U.S GOVERNMENT PRINTING OFFICE 1"?: 5U-Uo. IS 1-3

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