Radiation Dose Reconstruction Program of the National Institute for Occupational Safety and Health: overview.

Over the past 65 years, hundreds of thousands of workers have been engaged in nuclear weapons-related activities for the U.S. Department of Energy or its predecessor agencies. To date, almost 27,000 such employees (or their survivors) have filed claims under Part B of the Energy Employees Occupational Illness Compensation Program Act of 2000, which provides monetary compensation and medical benefits to energy employees who have developed certain types of cancer that have been determined, under the guidelines of the program, to have resulted from occupational radiation exposure covered under the Act. Although it is difficult to predict the number of cancer claims that will be evaluated under this program, the number could double or triple. In each case, the processing of a claim requires that the National Institute for Occupational Safety and Health reconstruct the radiation dose received by the employee followed by a determination by the U.S. Department of Labor as to whether the employee was "at least as likely as not" to have sustained the cancer as a result of his or her occupational exposure to ionizing radiation. Although some of the dose assessments are straightforward, many are extremely complex due to (1) missing, non-interpretable, or undocumented records; (2) a wide variety of external and internal exposure conditions; and/or (3) highly variable work assignments and work loads. The program objectives are to process claims in an effective, efficient, and timely manner. One of the initial challenges was to develop the necessary infrastructure to meet these objectives. Subsequent challenges included documenting that assessments are fair and scientifically consistent. Ensuring that each claimant receives the "benefit of the doubt" in any cases where the required background information and data are ambiguous or not available is also an important objective. Fortunately, there are some aspects of the processing requirements that have tended to reduce the complexity, two examples being that compensation is based on exposures that occurred during covered employment after a cancer has developed and that the required dose estimates are for individual body organs, not effective doses. Throughout the process, every effort has been made to ensure that the dose assessments have the support of the best available science.