ORP/CSD 72-1
     ESTIMATES OF IONIZING RADIATION
       DOSES IN THE UNITED STATES
                  1960-2000
•<$>
1
CD
           U.S. ENVIRONMENTAL PROTECTION AGENCY
                Office of Radiation Programs
               Division of Criteria and Standards

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      ESTIMATES OF IONIZING RADIATION
         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 werethe 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.  Element, 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.

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                               CONTENTS
                                                              Page No,

    PREFACE

I.  INTRODUCTION --			-	-	     I
    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 	100

     REFERENCES 			107

     APPENDICES TO MEDICAL RADIATION SECTION	-	Ill

     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
                                   iv

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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
                                  v

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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
                                                  s
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
II-'IS   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 States,.
        Population from Worldwide Distribution of   Kr	     48
11-23   Major Atomic Energy Commission Installations,	     55
                                   vi

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11-24

11-25

11-26

IIA-1
IIA-2

III-l
III-2
III-3

III-4


III-5

IIIA-1

IIIA-2

IIIC-1
IIIC-2
IIID-1

IIID-2

IIID-3
IIID-4

IIID-5

IV-1

IV- 2

IV-3 .
IV-4
Estimated Total Annual Whole-body Doses from Other
Atomic Energy Commission Installations 	
Estimated Internal Doses from Other Atomic Energy
Commission Facilities 	
Summary pf Estimates of Whole-body Environmental
Radiation Doses to the United States Population 	
Strontium-90 Intake 	
90
Fraction of 50-Year Sr Bone Dose Delivered After
Intake 	
Estimated Abdominal Dose from Diagnostic Radiology -
Estimated Thyroid Doses from Diagnostic Radiology —
Estimated Doses from the Diagnostic Uses of
Radiopharmaceuticals - 1966 	
Estimated Total Man-rem to the United States
Population from Medical Diagnostic Radiology, 1960 to
2000 	 - 	 - 	
Summary of Estimated Doses from Medical and Dental
Radiation 	
Summary of Information Relating to United States
Studies for Determination of GSD 	
Summary of Information Relating to United States
Studies for Determination of GSD 	
Patient Administration and Dose Administered - 1966 -
Dose per Administration 	
Exposed Population Radiation Therapy (Malignancies)
Age <30 	 	 - 	 	
Treatment of Cancer (Diagnosed 1955-1964) with
Radiation - A,ge <30 	
Estimated Gonad Dose per Treatment 	
Gonad Dose from Radiation Therapy of Malignancies
to Less Than 30 Age Group 	
Estimated GSD from Radiation Therapy (Malignant

Summary of Army Annual Occupational Doses - 1969 to
1970 	
Summary of Air Force Occupational Doses - 1969 to
1970 	
Summary of Navy Occupational Doses - 1969 to 1970 —
Summary of Atomic Energy Commission Occupational
Doses - 1969 	

56

57

60
74

76
88
89

92


99

101

115

117
121
123

125

126
129

130

132

137

138
139
i An
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
                                                      i
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 £o 2000	-_-r_-    153

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
                     89
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 of_ Populations;   1960,
     Vol. 1, Characteristics of_ 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-
                               1-7
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
                     8
using similar methods.  (Revisions of Reference 7 in preparation at the
time this report was being finalized indicate that the estimates at the
                                          g
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
Alabama
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
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakpta
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
                                     8

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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 th<
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-
                                              16 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 11-2.  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.
                              Table I1-2

           Estimated Annual External Gamma Whole-body Doses
                from Natural Terrestrial Radioactivity
                            (mrem/person)

Political Unit
Alabama
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
*As sinned to be
United States
Average Annual
Dose
70
60*
60*
75
50
105
60
60*
60*
60*
60*
60*
65
55
60
60*
60*
40
75
55
75
60*
70
65
60*
60*
55
40
65
equal to the
average .
                                   Political Unit
Average Annual
    Doses
                                   New Jersey              60  .
                                   New Mexico              70
                                   New York                65
                                   North Carolina          75
                                   North Dakota            60*
                                   Ohio                    65
                                   Oklahoma                60
                                   Oregon                  60*
                                   Pennsylvania            55
                                   Rhode Island            65
                                   South Carolina          70
                                   South Dakota           115
                                   Tennessee               70
                                   Texas                   30
                                   Utah                    40
                                   Vermont                 45
                                   Virginia                55
                                   Washington              60*
                                   West Virginia   .        60*
                                   Wisconsin               55
                                   Wyoming                 90
                                   Canal Zone              60*
                                   Guam                    60*
                                   Puerto Rico             60*
                                   Samoa                   60*
                                   Virgin Islands          60*
                                   District of Columbia    55
                                   Others                  60*
                                   Total  United States
     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

-------
                                                                    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,
                        22ft
  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
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.
                       i
     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

-------
                          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
                                    2 9 17
similar to those reported by others.' '
                              Table I1-3
          Estimated Average Annual  Internal Radiation Doses
from Natural Radioactivity in the United States

Radionuclide*
3
H
14c
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
Annual Doses (mrem/person)
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
 *Other natural  radionuclides  would contribute  to  doses  but  such a  small
  fraction that  they would not affect  the  totals within  the  accuracy  of
  these estimates.   As  an example,  doses from ^H are  shown here.
                                   12

-------
          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 11-5
:imatec

Year
1960
1970
1980
1990
2000
1 Total Annual Whole-body Man-rem from
in the United States

Population
(millions)
183
205
237
277
321
Natural Radiat:

Annual Man-rem
(millions)
23.8
26.6
30.8
36.0
41.7
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.
          -*• •  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 radionuclides 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
                        O A O tZ OR
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 28                                   90
"wet" and "dry" areas.  '    The average annual deposition of   Sr in
"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.
                        137                          29
      It is assumed that    Cs deposition is -1.6 times   that of
   Sr,  and that the  factor   for conversion of    Cs  deposition values
                                        —3                 2
 to open-field exposure rate is 1.7 x 10   (nR/hr.)/(mCi/mi.) .   Exposure
 rates  (p,R/hr . ) are  then converted to air dose rates  (ptrad/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
                            35 36
per unit of activity inhaled. '    The results are given in  Table II-6.
     Bfost 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
                               QQ    QQ    "I OT        "I O*T
     Doses due to ingestion of   Sr,    Sr,     I,  and    Cs have been esti-
mated using diet radionuclide concentration data from 12 cities.  >38
                                                       "I Of
(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 II-6
Estimated per Capita Organ Doses from Inhalation of Radioactive Fallout
(mrem accrued/yr.)
Lung Dosea Bone Dosea
Nuclide 1963 1965 1969 1963
54JtaC 0.96 0.16 b 	 	
55Fe° 0.02 0.01 	 	
89Sr° 0.60 0.01 	 0.08
9°SrC'd 0.43 0.09 0.01 0.28f
95Zr° 1.9 0.02 0.05 0.62
109cdc _ o.oi _ _
137CsC 0.23 0.06 0.01 0.03
144 f
Ce 8.2 0.38 0.31 10.6
QOQ ft -P
Pu 0.35g 0.06 0.08 0.14
239Pue 4.5g 0.78 0.16 1.9f
TOTALS 17.0 1.6 0.6 14.0
Does not include whole-body dose .
Dose 
-------
09
OC
OS
01
0
                                                                                        TJ
                                                                                        0
                                                                                        -%
                                                                                        o
                                                                                        (D
                                         o
                                         -h

                                         D


                                         (D

                                         D

                                  09    ~

                                         (D
                                                                                 09
                                                                                  OOL
    Figure II-l.  Respiratory Lymph Node  Dose from a One-Time  Exposure to Plutonium

    (Percent Delivered vs. Years After Exposure; Adapted from  Reference 36).
                                                                                        (D
                                                                                        Q.

-------
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
           14
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
                               90
delivered in 1 year except the   Sr doses which are delivered over  the
Table II-3.  The results are given in Table II-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 I1-2 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 I1-8.
     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,
                                                        40-42
waste and water management,  and use of geothermal energy.      Experi-
                                                             i
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 II-7
               Estimated Dose from Ingestion of Radioactive  Fallout
(mrem accrued/yr . /person) *
Year
1963
1965
1969
1980
1990
2000
*The
bone
are:
14c
Whole-body
0.3
0.7
0.6
0.6
0.6
0.6
90
0,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

890
Sr
Bone
1.3
0.2
0.2
0.2
0.2
0.2
900
Sr
Whole-body
7.3
7.2
3.2
3.2
3.2
3.2
The whole-body dose = 0 .
estimated

from Figure I I -3


Bone
73
72
32
32
32
32
1 times
for the

131
Thyroid
25
4
3
3
3
3
the dose to
years considered

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.

-------
  16OO
                                                      Age 60.
  14OO
§ 1200

(I)
i_
CD
a
\
E
0 10OO
Q)
tn
o
Q  soo


jC

13

E

O  400
   2OO
           Whole-Body Dose --1/10 Bone Dose
                                                Age 50
             196O     197O     198O     199O   2OOO    2O1O

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

        (U.S. Average).
                               20

-------
                  "S'fl) suot^Bindod
                                             QSOQ auog jg   pa^Bpiumoov  '£-11
                                                      06
   1200 -
c
0
CD
Q.  100O
E

-------
                              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
                                             QQ
   *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
          ission of worldwide  H and   Kr accumulation frc
          1.  Nuclear Electric Power Supply Requirements
                             3      85
is a discussion of worldwide  H and   Kr accumulation from all sources.
     Estimates have been made of worldwide nuclear electric power re-
                                                                    i
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   (GWE) 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-
          '•I                   '
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
                                                             i
                               Table II-9
                                                          43
           Estimated Nuclear Generating Plant Sites - 1990

Nuclear Plants by Capacity (megawatts electric)
Region*
Northeast
Southeast
East Central
South Central
West Central
t
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 II-5.
                                     23

-------
(0
-M
c
0)

E
Q>
0)
o:
o
o
ja>
UJ

TJ
0)

o

0)

[I
                              prre w seouQjejau raoaj pa^depy)
                                 ss^Bq.g pa^nn ptre
     30OO
     2000 -
                                                                                               CSI
      1000 -
                            198O
                                                1990
2OOO
                                      Year

-------
to
en
                                                                                                        V'---     JV.
                                                                                                        \  ..>    3
                                                                                                    EAST CENTRAL
                     ..I	i FEDERAL POWER COMMISSION
                     i..l"":  POWER SUPPLY AREA
                          REGIONS SELECTED FOX UPDATING
                           THi NATIONAL POWER SURVEY
                                                                                                                             0   100   100  JOOMiln

                                                                                                                             0 100 100  300 400 Xilemiuri
                                       Figure  II-5.    National Electric  Power  Survey  Regions.
                                                                                                           43

-------
                       40
begin operation by 1979.   These would have a total capacity of about
95 GWE 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

ME,
1
3
9(8)
20
24
33 ;
45

SE
0
0
1(D
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 abou^ 25  between 1970
 and 2000.  '     In  1960 there were 703 operating  underground uranium mines
 and 166 opqn pit mines.   The  numbers decreased  in  1961 to 497 and,122,
 respectively.  In  ^966, there  were 533  and 88.   By  1972 there will be  .
                             40
 21 uranium  mills  in  operation.   In JL970 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.  One  commercial
 fuel reprocessing  plant began  operation in 1966. Two Additional plants
                                                             40
 are planned to begin,operation in 1971  and 1974, respectively.    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

-------
               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.
       i
     Instances have been reported of contamination of streams near mills
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 basic
previously  discussed.
                                                          3   58    60
     The principal  radionuclides in reactor effluents are  H,   Co,   Co,
85^    890    90 _   131 _  131V   133_   134    1370      .    ^     _
  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-
                                             QC    "I. Q"l        "I OQ
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 raan-rem, and the average dose to the total
exposed population.
                                                            o
     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 of 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

-------
     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
                     55
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    -I 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
CO
        *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 nuclides 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
a
Fuel

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.
    bTreated 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-
                                o      iWt
leases used in this study.  All  H and   Kr is released through the
                                    33

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

and FBR Fuel Decayed 30 Days*




Concentration

Nuclide
3
H
85Kr
89

90
Sr
90
Y
91
Y
95
Zr
95
Nb
99
Mo
99mTc
99
Tc
103
Ru
106Ru
103mRh
11:LAg
115m
Cd
124
Sb
125Sn
125Sb
125m
Te
127m
Te
127Te
129mTe
129Te
132Te
129I
131I
(Ci/metric
In LWR Fuel In

692
11,200

96,000

76 , 600

76,600

159,000

276,000 2,

518,000 2,

—
—

14.2

89,100 1,
410,000 1,
89,100 1,
—

44.3

86.3
20.0
8,130
3,280

6,180
6,110
6,690
4,290
—
0.038
2.17
ton)
FBR Fuel

932
10,200

637 , 000

43 , 400

43,500

921,000

100,000

660 , 000.

1,810
1,730

14.9

760,000
290,000
760,000 •
12,600

269

76.7
6,720
19,600
6,860

61,100
61 , 800
181,000
116,000
4,170
0.053
139,000

Nucl ide
132

133Xe
134
-L W^ f _
Cs
136
Cs
137
Cs
140
Ba
140
La
141
Ce
144
Ce
143^
Pr
144
Pr
147
Nd
147T>_
Pm
149Pm
151Sm
152
EU
155
Eu
16°Tb
239XT
Np
238^
Pu
239
daPu
240^
Pu
241
Pu
241 .
Am
Cm
Cm



Concentration
(Ci/metric
In LWR Fuel

—
—

213,000

20.8

106,000

430

495

56,700

770,000
694

770,000

51.0
99,400
—
1,150

11.5

6,370
300
17.4
2,810

330
478
115,000
200
15,000
2,490

ton)
In FBR Fuel

4,300
74,400

29,000

28,800

109,000

523,000

601 , 000

1,480,000

1,280,000
644,000

1,280,000

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

*Reference 44, p. 8-14.
                                      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 Radionuclides
                  Present 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
8.5 x 10
          *Adapted from Reference 44, p. 8-12.
                                     —7        3
     A concentration factor of 5 x 10   (|j.Ci/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),
                                -7
the concentration factor (5x10  ), 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                 "
                             137         T  C
                           D(  Cs)      1Cs Cs
                                                       3
where C is the air radionuclide concentration  in |iCi/cm   and F is  the
gamma exposure rate constant for the radionuclides being  considered.
                   2
Its units are  (R-cm )/(hr.-mCi).  (See Appendix II-B  for  greater detail.)
Values of F were calculated  for each radionuclide using T values for a
                         59
specific gamma ray energy    and the number of  gamma rays  emitted per
     fiO
decay.   The    Cs dose was taken  from  a detailed calculation made  for
                             58
the Hanford, Washington, area.   Krypton-85  dose, values were taken  from
                        fi*l
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
               Fac  or -     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-
 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-
                    131       137                                58
 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
1. 85Kr
133
2 . Xe
3. All other

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

85
2. °°Kr

o 133V
3. Xe

. 144,,
4 . Ce

5. 131I
6. 129I
90
7. Sr
8. Pu
.
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
c
Lung
Annual Dose
(mrem/person
LWR Fuel



1.2

—

-3
<10




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
Accrued
at 3,000 m)
FBR Fuel



1.1

9.1

-3

-------
                        Table 11-16 - continued
Exposure
Pathway
9. Other actinides
,241 . 242 _
( Am, Cm,
244^_.
Cm)
10. All others
a
Body Organ
_ c
Bone
Lung
RLN
Lung
' Annual Dose Accrued
(mrem/person at , 3., 000 m)
LWR Fuel
0.2
0.8
100
~0.2
FBR Fuel
0.03
, 0.2
20
~0.1
 D.   Ingestion
from
surface deposition

1.

2.

3.

4.

5.
89
Sr
90 '
Sr
129

131
I
137
Cs
c
Bone
c
Bone

•Thyroid

Thyroid

Whole body
.
0.008

0.14

.11.2

13.0

0.02

0.004

0 .006

0.002

82

0.001
 a
  Doses to organs other than the whole body are in addition to
  whole-body doses.              '
  At 0.07 mm depth.                         ;
 C
  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 compared 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
131      137                                              31
   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
                              ii           .1
calculating these doses are given in Appendix II-B. ,
     Estimated doses from ingestion of radionuclides due to surface de-
position were based on calculations made for the Dresden Nuclear Power

                                    38

-------
       57
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	»eattle
          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
_ b,c
Bone ' l
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
     o
      At 0.07 mm depth.
      Includes whole-body dose.
     C          '  '
      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
                                                  !
                    I

of fuel processed per year.




                               Table 11-18



              Average Annual -Dose Accrued to the Population



            Within 100 Kilometers of a Fuel Reprocessing Plant

Q
Body Organ
Whole body
Skin
Lung
b
Bone
Thyroid
Respiratory
(per 300 metric tons
processed per yr.)
Accrued Dose (mrem/person/yr . )
LWR Fuel
0.17
1.6
0.25
0.21
0.84
lymph nodes 11
FBR Fuel
0.49
1.9
0.54
0.49
2.7
4.0
 Q

  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-

                                                            G

 tion living  within 100 km of the processing plant;  1.5 x  10 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 11-2,?.
     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-
                                                                        go
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 Organ Doses (mrem/p'erson)
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
Respiratory
Lymph
Lung Nodes *
0.001
0.03
0.1
0.2
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.
to

-------
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 3R
                            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
                      66
graphically summarized.   The range of most probable values is shown in
Figure I 1-6 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      S
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
                                              3           fift
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 reactor^ by several  methods.  The most impor-
tant of these methods are in the fission process itself and by neutron
                                   43

-------
aoBj-xng uj pue sjaqdsom^v
jo
                 PTJCQM
                                                                             '9-II
 10,000
U
                               A/ax/mf//777o/a///V  100 MCi
                                                            er_year from weapons
               Weapon Produced
                (6 - 10 MCi/MT)
Total of all ranges
            Naturally Produced
         (range of probable values)
                                      Reactor Produced
                                     (0,70-0.85 load factor)
    O.1
     1960     1965     197O     1975    198O     1985    1990     1995    2000
                                           Year

-------
interactions with boron in reactor control rods, with boron and  lith-
ium in the primary reactor coolant, and with deuterium in heavy  water
              fifi 6Q                                              3
(DO) reactors. '    For this study, it was assumed that (a) all H
  2
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
                                                               3
to the environment,  (c) that technological changes will reduce   H 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.  A  DO reac-
                                                               3
tor is assumedi to contain 430 kg of D00 coolant per MWE with a   H concen-
              '                                                      69
tration of 11 CiAg with 2.5% being lost per year to the environment.
                               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-
                             A
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
Ci/MWE/yr?6
                       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 137* in the year 2000 if the fraction
of D20 reactors is doubled, or the lower value can be decreased by about
10% if the amount of uranium-lueled 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
   3
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          W
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
                                                        70
in dose due to organic labeling through chronic exposure.
     The X can be estimated in several ways.  One is to divide the total
       3    W
world  H inventory by  the volume of circulating surface waters.  Surface
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
0.7  nCi/liter.
     The X  can also be  determined by direct measurement.  It  is found
           w
that X 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-
                                                                   g
dieted by the trend shown in Figure II-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
from Worldwide 3H

Year
1960
1970
1980
1990
2000
b.

Dose
(mrem/person)
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-
                                                   85
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 II-7 was obtained.  For the lower

                                    85
curve it was assumed that the total   Kr is distributed uniformly in

                    75            21                              3
the total atmosphere   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

85
  Kr 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 coneen-

                 5      3
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
     CO fif\

lungs.  '    Using these values and the upper range of air concentrations


in Figure II-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

-------
raoai saaudsiraaH
                                                                  •uof3.onpo.id

                                       aui UT uoTiBjq.uaouoo jv   p8q.BraT5.sg  • A-II
                                                          98
196O
   197O
1980

Year
199O
                                                                                               en
20OO

-------
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.
                                ye *7Q
     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.
                                          75,79,80
     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
                                                          131
fallout dose calculations were considered in II.  B.  Only    I and
137
   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
considered.
          ^'  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-
  84
ed.   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
   . 133T
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-
                                               QC
 ity  escaped  from  the cavity  to the environment.   The other two were gas
 stimulation  tests,  and no  radioactivity was found off the test sites
                           86,87
 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, dnly the former is discussed  (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
                                  Q 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
released from the well.  Only  H,   C, and   Kr were detected in the ef-
      QC
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.
     Mosft 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 Na'tional 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  I960; 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
                      89—101
made for this section.       Only the major ones contributing signifi-
cantly  to doses are listed in  the references.  Th6 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,  Oh Jo
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, Mi^amisburg, Ohio
National Accelerator Laboratory, Batavia, 111.              I
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

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

Year
"I960"
"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
en
05

-------
                                                          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
                                                Annual Average
                    Population at Risk               Dose
       Year  	(millions)	(mrem)
Lung
"I960"
"1970
Thyroid
"1960"
4.9
5.5
0.26
0.6
0.6
45b
         "1970"             0.1                       1.3
       Bone
         "1960"             0.26               •       4.3
         "1970"             0.1                       4.8
       _
        Do not include whole-body doses.
       b
        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

-------
     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                                         '
     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 I1-6
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
   85
of   Kr in Table 11-22; thyroid doses frorc 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
Radiation Doses
to the United States Population

Annual Man-rem (millions) for Years
Source
Natural
Cosmic
External gamma
Internal
Subtotal
Fallout
External gamma
Inhalation
Ingest ion
Subtotal
Other
Reactors
1960

8.2
11.0
4.6
23.8

l.ia
0.27a
1.0a
2.4a

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)
c
Man-rem/10
people
0.0088C

0.0026
0.015
24.8

183

136,000
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
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
Q
 of  all  environmental  radiation.
3                                                                 '
 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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                                     65

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                                      66

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77.  Public Health Service.  1970.  Final report of off-site surveil-
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83.  Public Health Service.  1966.  Ibid. PHOEBUS 1-A.  Report SWRHL-
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                                      67

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      1970 of  the  United  States Atomic Energy Commission.)  Washington.
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 90.   Brown, E.G.  and R.C.  Baker.   1961.  Environmental monitoring summary
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      Plant, U.S.  AEC report KY-371.  15  pp.

 91.   Davis, K.A.  and E.G.  Brown.   1969.  Ibid.  1968 and  1969.   U.S. AEC
      report KY-582. 14  pp.

 92.   E.I. Dupont  de Nemours.  1969.  Effect of  the Savannah  River Plant
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 93.   Honstead, J.E. 1970.  Quantitative evaluation of environmental
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 94.   Adams, P.C.   1964.   Environmental monitoring semiannual report:
      January-June 1964.   Monsanto Research Corp., Mound  Laboratory, U.S.
      AEC report MLM-1210.   16 pp.

 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
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      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.Ci 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
                                                    36
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-
                         105
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:
           106
     Infant   :  1st year dose:  1.24 rem/|iCi intake 1st year
                 2nd year dose:  1.52 -rem/(iCi intake 1st year +2.02
                 rem/|j,Ci intake 2nd year
                                   73

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                            Table 11A-1
                         StroBtium-90 Intake
                             (pCi/yr.)   :
1 1 	
Year
Pre-1954
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
Post-1970
Infant
. (ages 0 to 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
Teen
(ages 2 to 20)
0
580
1 , 680
2,700
2,700
4,560
6,600
5,020
4,300
5,980
17,700
16,400
10,840
7,960
6,263
5,970
4,818
4,640
4,640
Adult
(>age 20)t
0
386
1,120
1 , 800
1,800
3,040
4,400
3,351
2,869
3,986
9,395
9,373
7,380
5,234
4,840
4,073
3,635
3,570
3,570
Notes:
  Adult data:  1954-1959 ratio   Sr/Ca in milk104 (pCi/g Ca) x 400 =
                         pCi/yr. ("400" varies from 330 to 480 for
                         1960-1968) .
1960-197037 U.S. Average =
                                          New York + San Francisco
  Infant data:  0.5 of adult data
                                  7
  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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         Teen and adult  '    :   50-year dose (after age 2)
                              = 9.1 rem/^Ci intake during
                                1st two years
                              + 8.4 rem/jiCi 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
90                 107
  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.
                   D.  =  —- • — — rem/hr.
                    1    103    Mi
where n is the linear attenuation coefficient for air, C is  the  average
                                        3
air radionuclide concentration in jj,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 ^ 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
                                           r c
                          D(nuclide  i)      i i
                            D(13?Cs)      rCsCCs
    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 [iCi/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.)
        85Kr  Skin dose rate (0.07 mm depth) = • 3^°X  ? mrem/yr^9'61
                                  5X           61
              Lung dose rate =	L   7 mrem/yr.
                               o *  J.U •
       133
          Xe  Skin dose rate (surface) = 0.23EXAt (Reference 58)
              where I = 0.112 Mev (the average beta energy of 133Xe)
              and At = 3.15 • 10? sec./yr.
                                    77

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          -i oo
             Xe  Skin dose (0.07 mm depth) = 0.20 . surface dose.

                                    2.3X
                                                                58
Lung dose rate -
from a comparison
144
Ce Bone dose rate -
129
I Thyroid dose rate
131
I Thyroid dose rate
90
Sr Bone dose rate =
days/yr. • 0.7 •
Pu Isotopes and Other Actinides
3 . 10-7 «"'«WJU.
85
with Kr lung doses.
3 • 104X , 34
3 . io-9 **wyi.
1.5 • 104X , 34
3 • 104X , 34
6 • 10-10
3 • 104X , 34
— —" • • inrufli/ y r *
3 • 10-9
c o
X • 20 • 10 cm /day air intake • 365
3 35
10 mrem/50 yr./^Ci intake.
For    Pu:
                              3
     bone dose rate = 226 • 10  mrem/50 yr./|iCi intake,
                              3
     lung dose rate = 588 • 10  mrem/50 yr./^Ci intake, and
                                                fi                          oc
     respiratory lymph node dose rate = 132 • 10  (mrem/50 yr.)/|j.Ci intake.
                       240                                 239
     Plutonium-238 and    Pu were considered equivalent to    Pu because
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
      34                                           a
organs.   Whole-body MPC  ratios were used for bone and respiratory lymph
                        £L

node doses and lung MPC  ratios were used for lung doses.
                       o*
Other Nuclides
                      15 • 10 X      ,
     Lung dose rate = - rg — mrem/yr.

                                                       _Q       O
since the MPC  of most radionuclides is greater than 10   ^Ci/cm.  Those

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

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     3.  Doses Due to Ingestion of Surface Deposition
         Dose values from Dresden calculation:
                                             57
Nuclide
89
Sr
90
Sr
i ^n
I
137
Cs
Critical
Organ

Bone

Bone

Thyroid

Whole-body
Release Rate
(pCi/sec.)

7,300

5

550

123
Dose at 3,000 m
(mrem/yr . )
-3
5.4 • 10
-5
8.2 -10
-1
3.4 • 10
-4
1.8 • 10
129
   r      -^ ^      c
   I thyroid dose = 5 •
                                   I pa

                                  (I)   131T J
                                       - •    I dose • 10
                             R.R.
                                      •1 OQ     1 O*|

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
j.ndex of radiation received by the genetic pool.  This index permits
comparisons between diverse national surveys and serves as an important
                                    83

-------
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
where D. = the average gonad dose to persons age i who receive
           x-ray examinations,
      N. = the number of persons in the population of age i who
           receive x-ray examinations,
      P."= the expected future number of children for a person,
           age i* and
      N. = the number of persons in the population of age i.
      The magnitude of x-ray dose to segments of the United States popu-
                                                              1-10
 lation-has been reported in numerous studies (Appendix III-rA) .     These
 studies have been limited to estimations of GSD or, in some cases, to
 gonad dose.   Populatipn 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
                                                                      t
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
     .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)]  * [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?* 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
                          i
report, nor have these estimates been used to develop values for other
                                        i 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 mrem 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)
Year
Annual per Capita                             Annual per
   Dose for the     Size of               ;   Capita Dose  for
Exposed Population  Exposed      Fraction  of  the  Whole U.S.
      (rorem)        Population   Whole  U.S.   Population
Male  Female  Both   (thousands)  Population      (mrem)
1964
Radiography 150 126 138 66,086
Fluoroscopy 273 318 296 7,779
Total
1970*
Radiography 148 156 153 75,400
Fluoroscopy** 269 394 328 8,600
Total

0.354
0.042


0.377
0.043


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

-------
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-
                       x
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.
                                                     12
     During 1964, 226,700,000 dental films were taken.   According to the
distribution of film types used   and estimates of thyroid dose per
                       "L fi 17
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
 Size of
 Exposed
Population
Fraction of
Whole U.S.
Annual
per Capita
Dose for the
Whole U.S.
Population
Source
Examinations of
head and neck (1964) A
Examinations of
chest and thorax (1964)
Dental examinations
(1964)
(mrem)
172
69
57
(thousands)
7,500
51 , 100
45,900
Population
0.04
0.27
0.25
(mrem)
7
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
                                                           i   '     *'
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
    no'                                                  1 on       22
year.  ' This analysis was based on  ihe 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 30,  indicated that
the total accumulated patient gohad dose accrued from  the  diagnostic use
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 genetically  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-
nostic1 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  aiso below age 30,
 then the 1966 estimated annual GSD  is  0.26 mrem  from tne  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) radiophar-
                                    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-
                                                 20
tered.  During a 1966 Public Health Service study,  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 speqific 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-
             131                                                    131
istration of    I.  Most^f 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 jj.Ci and the average activity admin-
                                   20
istered per thyroid scan was 46 u.Ci.    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
                                          2
quantities recommended in current practice.'
*5-10uCi for uptake and 50-100u€i for scan.
                                          21
quantities recommended in current practice.   Using the reported data,
                                    91

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                                Table II1-3
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 radionuclides
TOTAL

Gonads
131
I thyroid function
131
I thyroid scanning
131
I other
2°3Hg
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 10
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
1 44

279



Size of
Exposed
Population
(thousands)


481
481

252

320
\
104

2
339



481
252
320
89
356

t

481

252
320

445


i 1

Fraction of
Whole U.S.
Population


0.0025
0.0025

0.0013

0.0017

0.0005
-5
10
0.0018


I
., 0.0025
0.0013
0.0017
0.0004
0.0019

1

0.0025

0.0013
0.0017

0.0023

Annual
iper 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
0425
1.0


0.14

0.12
0.07
j
0.64
1/0 ^
*Based on recommended activity
**Based on small survey sample
per administration.
                                       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-
               99m'                   99m   99
pharmaceutical    Td, 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
                large.
               b.  Radiation Treatment of Nonmalignant Diseases
                     19
manner would be large.
     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
        2fi 27
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
                            19
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 dose.  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 J.,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
                                       g
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
                             g
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.   If^ 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.
                                     98

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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 II1-4
         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
           1 36                       32
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  II1-5.
      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 II1-5
Summary of Estimated Doses
from Medical and Dental Radiation

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

Medical and dental
diagnostic radiography
Same
Radiation therapy
Radiopharmaceut ical s
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)
7,780J
75,400)
8,600 J
1,500
Annual per
Capita Dose
Fraction of for Whole U.S.
Whole U.S. Population
Population (mrem)

55
36°
5
0.3
0.40 61
0.42 72°
0.008 1
  (continued)

-------
                                            Table  II1-5  (continued)
     Dose Category
     or Organ	
                          Source
Annual per
Capita Dose
for Exposed
Population
  (mrem)
Size of
Exposed
Population
(thousands)
Fraction of
Whole U.S.
          Q
Population
Annual per
Capita Dose
for Whole U.S.
Population
  (mrem)
o
to
     Whole-body dose
     occupational  (1968)
     Organ
       Thyroid  (1964)
Thyroid (1966)
                       Medical workers
                       Dental workers
                       Radiopharm. and
                       radium workers


                       Medical radiography
                         Examinations of
                         head and neck
                         Examinations of
                         chest and thorax

                       Dental radiography
    320
    125

  262-540
                                                        172

                                                         69

                                                         57
                            Diagnostic use.s
                            of radiopharm.
                              131
                                 I thyroid function          _e,
                              function             5 to 15x10
                              131,  ..
                                 I  thyroid scan
                              'Other
                                                 78x10
                                               Depends on
                                               radippharm.
                                                                         454
                 0.002
                    0.6
                  7,5001

                 51,100!

                 45,900
                 0.31


                 0.25
                   26


                   14
                                                                      1,500
                                                                               0.008 "
                                               143
     o
      Based on civilian non-institutionalized population only.
      GSD applicable to whole United States population.
      ,Preliminary information.
      Ovarian and "simulated ovarian" doses.
     0
      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 cap-ita 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
conclusioh 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 19.64 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

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                                 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 characteristics 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 medical 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., Rad. Therapy Nucl.  Med. 90:   404-417.

 6.  Morgan,  R.H. and J.C. Gehret.   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 Healrth.   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 ^n the
      Treatment of_ Diseases of_ the Skin.   Lea and Febiger,  Philadelphia.
      830 pp.

 27.   Witten,  V.H.,  M.B. Sulzberger and W.D.  Stewart.   1957.  Studies
      on the quantity  of radiation reaching the gonadal areas during
      dermatologic X-ray therapy.   AMA Arch.  Dermatol. 76:   683.

 28.   United Nations.   1962.   Report of the United Nations  Scientific
      Committee on the Effects  of  Atomic  Radiation.   Supplement No.  16.
      (A/5216).  New York.   Annex  G, Tables XXI to XXVII.

 29.   Pettigrew,  G.L.   1970.   Memorandum  to Director,  Bureau of Radio-
      logical  Health.   U.S.  Public Health  Service.

 30.   Fess,  R.L.   1969.  Summary of diagnostic X-ray statistics relating
      to facilities, equipment  and personnel  by healing arts professions.
      Radiological Health  Data  10:   379-380.

 31.   Public Health  Service.   1966.  Protecting and improving health
      through  radiological  sciences.   National Advisory Committee on Rad-
      iation,  Washington,   vi,  27  pp.

 32.   Gitlin,  J.N.  1971.   Preliminary estimates  from  the U.S.  Public
      Health Service.   1970.   X-ray exposure  study.  Paper  presented at
      the Roentgen Ray Society  Meeting, Boston,  Mass.,  September  29,  1971.

 33.   Hemphill,  F.M.,  F.B.  Locke and R.D.  Hesselgren.   1970.  Diagnostic
      radiation utilization in  selected short-term general  hospitals.
      Public Health  Service,  Bureau of Radiological  Health  report
      BRH/DBE  70-8.  ix, 52 pp.

 34.   Epp, E.R.,  et  al.  1963.  Measurement of bone  marrow  and gonadal
      dose from X-ray  examinations of  the  pelvis,  hip  and spine as a func-
      tion of  field  size,  tube  kilovoltage and added filtration.   Brit.  J.
      of Radiol.  36:   247-265.

 35.   Brown,  R.F., B.M. Burnett and V.  Senary.   1971.   An acceptable gonadal
      shield.   Radiology 99:   265-269.

36.   Public  Health Service.   1962.   Volume of X-ray  visits  1961.   U.S.
     National  Health Survey,  Series B,  No. 38.  57 pp.
                                       109

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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

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       APPENDICES
           TO
MEDICAL RADIATION SECTION
         111

-------
        APPENDIX III-A

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

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Table IIIA-1
Summary of
Study and Location
Public Health
Service/National
Izenstark & Lafferty/
New Orleans, La?
Pasternak & Heller/
New York, N.Y4
Cooley & Beentjes/
Calves ton, Tex.
/
Morgan & Gehret/
Baltimore, Md6,
Billings, Norman, &
Greenfield/
Los Angeles, Calif.
Laughlin & Pullman8
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 for Determination of GSD
Site or
Sampl ing See
Source Footnotes
Household a,b,c
interview
Hospitals & c
offices
Gen. , TB & a,c
mental hosp.,
el ins., offs.
University a,b,c
hospital
Teaching a , c
hospital
Large private & d
general hosp. ,
childrens clin.
Based on a,b,d
published
literature
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
-
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
Statistics -
1960
National Center
for Health Sta-
tistics, 1963
-
American Medi-
cal Directory,
1950. 1956
 (continued)

-------
                                       Table  IIIA-1 - continued
Study
and Location
Brown, Heslep,
San Francisco,
& Eads/
Calif?
Year
1956-
1957
Approx . No
Persons
x rayed or
Exams .
110,000
exami-
nations
Site or
Sampling
Source
Medical ins .
hospital
See
Footnotes
a,d
Source of
1 at ion Age
tribution
Study
itself
Popu-
Dis-
Data

Source of Age-
Specific Child
Expectancy Data
-

Norwood, Healy,
Donaldson, Roesch, &
Kirklin/
Richland, Wash.
1953-     85,000
1956    exami-
        nations
Hospital &
offices
a,b,c,d
Study
itself
Study itself
a
 Flouroscopy included.
b
iDentistry included.
c
 GSD based on age distribution ano child expectancy.
 GSD equivalent to 30-yr. gonad dose.

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                                            Table IIIA-2
         Summary of  Information Relating to United States Studies for Determination of GSD
Study and Location
Public 'Health ,
Dose Model
Employed
Phantom & human
Actual Measure-
ment of X-ray
Machines Made
During Study
Yes No
X
Method of Measure-
ment of X-ray
Machines During
Study
Various film packs
GSDa
(mrem)
55
Service/Nat ional
subjects
                 depending on procedure
Izenstark & Lafferty/
New Orleans, La.

Pasternak & Heller/
New York, N.Y4

Cooley & Beentjes/
Galveston, Tex?
Morgan- & Gehret/
Baltimore, Md?
Phantom
Model based on
phantom

Phantom, human
subjects &
fublished lit.

Calculational (rela-
tionship between
abdominal & gonad
dose)
                  Assortment of-ioniza-
                  tion chambers and/or
                  monitoring films

                  Differential-type
                  ionization chambers
                           (New     75
                           Orleans)

                          (New York 50
                           City)

                                    18
                                    23
Billings, Norman, &
Greenfield/Los Angeles,
Calif!
                  8
Laughlin & Pullman
Brown, Heslep, & lads/
San Francisco, Calif?

Norwood, Healy, Donald-
son, Roesch, & Kirklin/
Richland, Washi0
Phantom & human
subjects
Based on published
literature

Based on published
literature

Phantom &
published
literature
Partial
Ionization chambers
                                              (L.A.    61
                                             hospital)
                                           (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.

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                             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^

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:
                       l fi
    14 periapical films
    @ 65 kVp 2.1:1.3 =1.61
    @ 90 kVp 79:48 = 1.64.
    279 mR lens of eye/examination           _,  *,_    ., ^  ^   /    -   j. •   *
5.  	=—^75	  = 172 mrad  thyroid  dose/examinationt
                  1 . D^
                                                               9
6.  7,519,000 examinations x 172 mrad/examination  _ 1.293  x 10    g  g mrad
              187 x 10  whole population             187 x 10      annual
                                                                   per capita
                                                                   thyroid dose,
                                                    j
                     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
        ...   .   _       , .  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:

    No. chest films (photofluorographic)12  (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
                                        i
                                      Total = 3,600,000 rad.
                              = 0-069 rad  = 69 mrem to person in
                                             exposed population.
                         .
     51,100,000 persons at risk
    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.

2.
          6         17
226.7 x 10  films/yr.
                        15
Distribution by film use   (percent).

Film type      Bite wing      Periapical
A
B
C
D
3
48
17
32
3
47
18
32
                                            17
3.  Distribution of film use by type of film   (percent).
    Periapical
    Bite wing
                67
                33
4.  Thyroid dose per film (mrem).
           Bite ,wing                 Periapical
Film Speed Dose
A 44
B 221?
C 11
D 5.5
5. Dose (1964):

p 226.7 x 106 x 0.33
Film Speed Dose
A
B
C
D

Bite wing
(0.03 x 44) +
27.2
13.6
6.817
3.4


(0.48 x 22) + <






[0.17 x 11) + (0.32 x 5.5)
                                 45.9 x 106
   = 25.279 mrem mean annual dose to person in population at risk.
                                    119

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                               Periapical


  226.7 x IP6 x 0.67  (0.03 x 27.2) +  (0.47 x  13.6)  + (0.18 x 6.8)  + (0.32 x 3.4)

-                             45.9 x 10«>"


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

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

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                                     APPENDIX III-C
                                  Radiopharmaceut icals
                                     Table  IIIC-1
                 Patient Administration and Dose Administered -  1966
Radionuclide and Form
                           Procedure
Estimated number
   of patient
administrations
     (1966)
   Dose
administered
 (nCi/70-kg
   adult)
  Nal
  Nal
  Labelled albumin
  Labelled albumin
  Labelled albumin
  Labelled albumin
  Labelled albumin
  Labelled albumin
  Labelled albumin(MAA)
  Sodium lodohippurate
  Sodium lodohippurate
  Labelled fat?
  Rose Bengal
  Rose Bengal
125,
  Nal
Other radionuclides
  57
  60
Co Labelled Vita-
   min Big
Co Labelled Vita-
       min B
  51
  51
  51
           12
Cr Sodium chromate
Cr Sodium chromate
Cr Heat-treated red
   blood cells
  59
   Fe  chloride or
       citrate
                      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 B,2 absorption
Blood volume
Red blood cell survival

Spleen scanning

Iron turnover
    481,830
    252,567
    163,418
      2,527
      6,753
      6,077
        675
        337
     37,817
     53,069
      3,376
     12,635
      1,685
     32,415

      2,026
     39,591

     26,113
     36,221
     10,108

      2,701

      5,054
     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

    225

      7.5
                               (continued)
                                     121

-------
                             Table  IIIC-1  -  continued
                                                   Estimated number
                                                      of patient
                                                   administrations
 203
  203
  197
  197
Hg labelled mer-
   curials
Hg labelled mer-
   curials
Hg labelled mer-
   curials
Hg labelled mer-
   curials
  Mercurihydroxipropane
  85
    Sr nitrate or chlo-
       ride
  75
    Se selenomethiodine
Brain scanning

Kidney scanning

Brain scanning

Kidney scanning
Spleen scanning

Bone scanning
Pancreas scanning
62,128

27,012

30,389

11,480
   675

   675
 2,701
                                                                      Dose
                                                                    administered
                                                                    (|aCi/70-kg
Radionuclide and Form
99m
Tc pertectnetate
Tc pertectnetate
Tc sulfur colloid
99m
Tc labelled albumin
99m
Tc labelled albumin
198
Au collbidal gold
Procedure
Brain scanning
Thyroid scanning
Liver scanning

Placental scanning

Lung scanning

Liver scanning
(1966)
103,998
337 '
4,911

205

205

68,881
adult)
7,936.6
2,000
2,971.6

1,000

1,000

175.0
  700
     t
  116.6

1,000

  144.4
  300

2,000
  125
a,,               20
 Represent  returns    from  54% of queried,  corrected to estimate total patient
 administrations.
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

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                                           Table  III-C-2
                                      Dose per Administration
                                                                                    Dose (mrad)
Radionuclide and form
                                                 Procedure
                                                            Whole body
                                                   Gonad
                          Thyroid
to
CO
13\I
  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.
         Other Radionuclides
           57
           6°
           51
    Co labelled Vitamin B
    Co labelled Vitamin B
    Cr sodium chromate
12
.0
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
Blood volume
            (continued)
55
91
11
40
14
800
600
315
65
5
24
29
7
105
69
114
" 30
110
39
2,200
1,650
867
208
25
-
-
-
_
46,750
77,690
193
800
248
14,000
10,500
5,519
9,110
1,575
7,000
-
-
_
  1.75
210
  5.5
                                                                               50
                                                                              280
                                                                                6.8
                                                                                                   67,500

-------
                                        Table  IIIC-2  -  continued
Dose (rarad)
Radionuclide and form
Cr sodium chroraate
Cr heat-treated red
blood cells
Fe chloride or citrate
Tc pertectnetate
99mm . __ . .
Tc pertectnetate
99m
Tc sulfur colloid
Tc labelled albumin
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
*Product of activity per administration and dose   to specific organ per unit activity.

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

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

Rate/100,000
in Conn.23 1966
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
Male
1
_
1
1
-
—
1
1
2
-
-
-
2
11
2
1
1
9
2
9
4

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

8
1
7
3
17
12
Site
Buccal cavity & pharynx
Stomach
Large intestine
Rectum
Liver, bile duct
Other, digestive
Nose and nasal cavity
Lung bronchio-tracheal
Other, respiratory
Breast
Expected number
of cases in U.S.*
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
Conne ctive 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
at
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,
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 vr.
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)
      ear, etc.
                                                        (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
Test is
Penis , other
male genitals
Kidney
Bladder
Other, urinary
Lower GI, NOS
Melanoma
Other skin
Eye
Brain, other nervous
system
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
•s<
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
(continued)
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
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

-------
                                            Table III-D-2  (continued)
to
00
Treated with
Radiation
Site
Thyroid
Other endocrine
glands
Bone
Connective tissue
Ill-defined sites
Lympho/r e t i cul o
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
-



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
*Depends on site-assumed,  treatment situated on lower

 abdomen,  pelvis or upper  thigh.
                          129

-------
                                                    Table  III -D-4
                  Gonad Dose from Radiation Therapy of Malignancies to the Less Than 30 Age Group
        Site
                        Product of Percent-
                       age of Population <30
                      Treated by Radiation &
                       10-year Survival Rate
                        Estimated Population
                        <30 Having Malignancy,
                        Receiving Radiation,
                        & Surviving >5 Years
                         Male        Female
                                      Gonad
                               (patient-rem per year)
                                 Male         Female
CO
o
Buccal cavity
  and pharynx
Stomach
Large intestine
Rectum
Liver, bile duct
 i
Nose and nasal
  cavity
Breast
Lung, bronchi and
  trachea
Other respiratory
Kidney
Bladder
Other urogenital
Melanoma
Eye
Brain
Other central
  nervous system
0.10 (0.145 x  .70)

0.04 (.22 x .16)
0.01 (.02 x .70)
0.03 (.06 x .50)
0.03 (.19 x .14)
0.33 (.66 x .50)

0.12 (.42 x .29)
0.04 (.34 x .11)

0.48 (.53 x .91)
0.30 (.78 x .38)
0.08 (.10 x .84)

0.01 (.02 x .64)
0.26 (.33 x .81)
0.14 (.51 x .28)
0.14 (.51 x .28)
      55


       5
      17

     183


      22

     532
     332
      44

      50
     288
     698
     310
(continued)
                                                                      21
                                                                      16
                                                                      16
                                                                      16
                                                                      66


                                                                     258
                                                                     323
                                                                      48
                                                                     140
                                                                     980
                                                                     301
    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
   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

-------
                                              Table  III  D-4 (continued)
                              Product of Percent-
                             age of Population <30
                            Treated by Radiation &
Estimated Population
<30 Having Malignancy,
Receiving Radiation,
& Surviving >5 Years
       Gonad
(patient-rem per year)
Site
Thyroid
Other endocrine
Connective tissue
Lymphoma
Leukemia
Other
TOTAL
10-vear Survival Rate
0.21
0.19
0.08
0.25
0.02
0.14

(.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
Male
261.4
4,693.5
49,914.2
325,454.7
24,616.3
13,697.3
448,363.9
Female
904.0
41,310.0
72,240.0
480,480.0
27,090.0
33,900.0
690,276.2
CO

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

Area of Body
Male genitals
Male pelvic region
Male - other
Fertility
Index
Relative „
to Normal
0.02
0.40
1.0
Annual Cumulative
Patient-rem
Male
490,670
1,936
Female
-
Annual Cumula-
tive Patient-
rem Corrected
for Fertility
196,268
1,936
Female pelvis (bladder,
  cervix, rectum, and
kidney) 0.0
Female pelvic region 0 . 4
Female - other 1.0
- -
681,184
3,545
—
272,473
3,545
474,249 patient-rem _ .
Nnto- 	 . •! . i • i — B.I mTem .
       93.5 x 10  population under 30
                                   132

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IV.  OCCUPATIONAL DOSES

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                      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 a-ejported 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
                                                    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 XL. 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
               . *                          "i.
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-
                  5,6
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
Percent of
Workers'
23
19
1
3
19
12
i
8
4
1
10
100
Mean Annual Dose
(mrem)
101
77
67
100
68
79
i
67
89
461
98
88
Percent of Workers
Dose Range (rem/yr.)
0-0.049 .049-. 099 .1-
95.7 2.4 0
.299 .3-. 499 .5-1.49 1
.9 0.6 0.3
.5-2.99 3-4. ft9 >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 Center7 (see Table IV-3).
                                    138

-------
                               Table IV-3
            Summary of Navy Occupational Doses - 1969 to 1970

             -Mean Annual Dose
        Job Category 	Percent of Workers	(mrem)
Medical
Industrial
TOTAL
10
90
100
83
211
198
               d.  Atomic Energy Commission
     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 rems.  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-
                                                                    g
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


Number


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
                                                                    T •"'
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 non-re^ported Atomic Energy Commission licensees in summary
tables below.
                                    141

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                              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-
               12
latory programs.
     Exposure data for 1970 comparable to that of Atomic Energy Commission
licensees were provided for this study through the Atomic Energy Commis-
                                  g
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 Heal ing 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 mrem.
                               Table IV-8
             Wisconsin Dental Facility Survey - 1969 to 1970

Number
Surveyed
4,175
Assumed mean
Number
Total man-mrem/wk .
Percentage in Dose
0-10 11-50
93.6
1
3,908
3,908
5.8
30
242
7,260*
Rate Range (mrem/week)
50 - 99 >100
0.6
75
25
1,875
0*
140
0
0
     *0riginally 4 individuals;  review indicated improper handling of
      badge.  Resurvey of these placed them in a lower range.

                                   143

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     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
Ch iroprac tor
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

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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
                                 16
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
                19 20
period of 1 year^ '     Of the individuals monitored, approximately 88%
                                   145

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                                                            Table  IV-10
Oi
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 genera], 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

-------
                                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 & ray
Medical radium
Nonreport ing
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

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                               Table IV-12
Percent

Reporting '
Agency
r
AEC
State
a
licensees
AEC
licensees
Army
Air Force
PHS
Navy
of Employees

Number of
Employees 0
102,918
24,519
62,090
22 , 790
(7,445)C
34,975
(17,591)°
508
55,051
in


- 1
95.8
96.2
95.8
99.0
99.0
99.0

Annual Dose Ranges - 1969 to 1970

Dose Ranges (rem)
1-2 2-3 3 - 4 4-5
2.5 1.3 0.3 0.1
3.2 1.3 0.4 0.2
2.3 0.9 0.3 0.1
1.0
1.0
1.0
Not available


>5
0.0
0.6
0.3
—
—
-

a!5 of 17.
b~40%.
cNo. >10 .mrem/yr.
Research and
  industrial use
                               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
318.3
1.55
49
0.2
                                    149

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       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
                I
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-
                                                                i
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
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

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 tfte 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 Healtti  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.
                                   152

-------
15.  Illinois Department of Public Health.  1971.  Summary of whole-body
     exposure reports.  Springfield,  Illinois.  (Unpublished data.)

16.  Fuller, 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.%., 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 jin 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

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                      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

                                                                        1
                3
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 - 1970 to 2000
Year
Emission rate (mR/hr. at 5 cm)
Mean dose (mrem)
Age-<15 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
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
                                                c
were sold during the year June 1969 to June  1970.  During  this  same  period

                                    158

-------
                                                     147
approximately 1 million watches with 30 to 50 p.Ci of    Pm were made
                       6
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
                                      7 8                          147
using wrist watches containing tritium,'   while watches containing    Pm
                            Q
give doses in the jurem 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-
             g
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 ajr crew members has not been obtained.  However,  the total
number   of aircraft owned and leased by air carriers in 1969 was 2;638.
                                    159

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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
            9
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
mrem
0
0.1
0.1
0.1
0.1
man-rem
26
30
36
41
0
,000
,000
,000
,000
Consumer Products
mrem
1.0
1.5
1.0
0.01
0.01
man-rem
180
310
240
3
3
,000
,000
,000
,000
,000
Air Transport
mrem
1.0
1.0
1.0
1.0
1.0
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,
     Anniston 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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100-
                                              Total
  10-
                                             Natural

                                             Medical
0)
c
o
E  i

-------
 100-
  1O-
c
o
(0
k_
0
Q.
\


0)
    T-
  O.1-
                       Total


                       Natural

                       Medical
                       Global Fallout
                       Miscellaneous

                       Occupational

                       Other
                        Environmental
   1960    197O
1980
Year
199O   .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 to 2000

Radiation Source
Environmental
Natural
Global fallout
All other
Subtotal
Medical
Diagnostic *
Radiopharmaceut ical s
Subtotal
Occupational
Miscellaneous
TOTAL
Population (millions)
Per capita dose (mrem)
Ma-n-rem (millions)
1960 1970 1980
23.8
1
0.015
24.8
13.2
0.07
13.3
0.14
0.36
38.6
183
211
26.6
0.82
0.012
27.4
14.8
0.4
15.2
0.16
0.55
43.3
205
211
30.8
1.1
0.022
31.9
17.1
3.3
20.4
0.19
0.51
53.0
237
224
for Years
1990 2000
36.0
1.3
0.062
37.4
19.9
4
23.9
0.24
0.32
61.9
277
224
41.7
1.6
0.15
43.4
23.1
5
28.1
0.28
0.36
72.1
321
225
*Medical  diagnostic  man-rem doses based on an index of somatic 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 manmade 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 thkt, 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.  J£ this balance between increasing usage and technical improvement
is real,  and jlf_ 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,  JCf_
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
 «U.S. GOVERNMENT PRINTING OFFICE: 1972 514-146/18 1-3

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