Since the mid-1940s, hundreds of thousands of workers have been engaged in nuclear weapons-related activities for the U.S. Department of Energy (DOE) and its predecessor agencies. In 2000, Congress promulgated the Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA), which provides monetary compensation and medical benefits to certain energy employees who have developed cancer. Under Part B of EEOICPA, the National Institute for Occupational Safety and Health (NIOSH) is required to estimate radiation doses for those workers who have filed a claim, or whose survivors have filed a claim, under Part B of the Act. To date, over 39,000 dose reconstructions have been completed for workers from more than 200 facilities. These reconstructions have included assessment of both internal and external exposure at all major DOE facilities, as well as at a large number of private companies [known as Atomic Weapons Employer (AWE) facilities in the Act] that engaged in contract work for the DOE and its predecessor agencies. To complete these dose reconstructions, NIOSH has captured and reviewed thousands of historical documents related to site operations and worker/workplace monitoring practices at these facilities. Using the data collected and reviewed pursuant to NIOSH’s role under EEOICPA, this presentation will characterize historical internal and external exposures received by workers at DOE and AWE facilities. To the extent possible, use will be made of facility specific coworker models to highlight changes in exposure patterns over time. In addition, the effects that these exposures have on compensation rates for workers are discussed.
Since the mid-1940s, it has been estimated that 650,000 workers have been engaged in nuclear weapons-related activities for the U.S. Department of Energy (DOE) or its predecessor agencies. In 2000, Congress promulgated the Energy Employees Occupational Illness Compensation Program Act of 2000 (
Although the Presidential Executive Order assigned primary responsibility for administration of the program to the DOL, the U.S. Department of Health and Human Services (DHHS) was assigned the task of fulfilling several important supporting technical and policymaking roles. The National Institute for Occupational Safety and Health (NIOSH), a component of the Centers for Disease Control and Prevention, is named under EEOICPA to assist the Secretary of DHHS to implement her responsibilities under the Act. Under EEOICPA, the NIOSH is required to reconstruct radiation doses for those workers who have filed a claim, or their survivors who have filed a claim, under Part B of the Act. The DOL uses the results of these dose reconstructions to determine eligibility for compensation under the Act. Under Part B, compensation decisions for a covered cancer are made by DOL based on a probability of causation calculation. Using the Interactive RadioEpidemiology Program (
Of the >39,000 cases received for dose reconstruction thus far, most are men, but a significant proportion of the cases (13%) are women. Given that EEOICPA covers exposures going back to the early 1940s, a significant portion of the claims (28%) have been filed by survivors (i.e., spouses or children) of former workers. As also might be expected, given the size of the DOE complex, the majority of the cases (84%) are from workers or former workers at DOE (or its predecessor agencies) facilities.
Beginning with the establishment of the Manhattan Engineer District (MED) in 1942 and continuing through the present, the activities involved in the production of nuclear weapons encompass a wide range of technologies. As discussed in the DOE publication,
Starting with the creation of the MED in 1942 and continuing through the early 1950s, there was a demand for large quantities of purified uranium that would be turned eventually into uranium metal and rolled into rods. To meet this early demand, the MED [subsequently the Atomic Energy Commission (AEC) beginning in 1946] contracted with a number of commercial facilities to develop processes for separating uranium from ore, converting the purified compounds of uranium metal, and shaping the metal into rods.
There are a number of processes involved in the refinement of uranium, including ore handling, chemical extraction, denitration, oxide reduction, and reduction to metal. While there were several commercial facilities involved in the refinement process, the Mallinckrodt Chemical Company serves as a good example of the types of exposures encountered at these early facilities. The MED asked the Mallinckrodt Chemical Works in April 1942 to begin research on uranium refining and processing operations that could lead to large-scale uranium production operations. The work began immediately, and by July 1942, Mallinckrodt was producing almost a ton of UO2 per day (
The exposures at these early AWE facilities that refined uranium were characterized by high concentrations of airborne uranium, with airborne levels exceeding hundreds of times the then maximum allowable concentration of 70 dpm m−3.
On a number of occasions, the uranium extraction operations during this period involved the processing of high-grade uranium ore, which contained equilibrium quantities of uranium progeny. Because of this, the external exposure environment had levels of gamma radiation that could easily produce annual exposures of 20 R y−1. As an example,
The ore refining process separated the progeny that was originally in secular equilibrium into several waste streams, creating isolated pathways where one or more of the progeny could become concentrated. Notably, 230Th was known to concentrate in the filter cake in one portion of the refining process. Thus, the potential for unmonitored exposure to this source term was created. In addition, 222Rn was also present at any facility that handled uranium ore in equilibrium with its progeny. Radon, being a chemically unreactive gas, would readily accumulate in areas where ore was processed and stored, particularly in locations with minimal ventilation. An example of the levels of radon that existed at early ore processing facilities is provided in
Subsequent to the production of purified uranium compounds, much of the material was converted to metal and eventually shaped into rods for use as targets in reactors. As with the chemical processing operations, the AEC relied on existing commercial or research facilities to perform this conversion. Early in 1942, faculty members in the Chemistry Department at Iowa State College in Ames, Iowa, with expertise in rare earth metallurgy, were called on to develop a method to produce uranium metal. By November 1942, successful methods had been developed, and approximately one-third of the uranium used in the Chicago pile was supplied by the Ames Project. Between mid-1942 and August 1945, >1,000 tons of pure uranium metal was supplied to the Manhattan Project. Eventually, uranium production was established at a number of commercial facilities, including Harshaw Chemical Company, Mallinckrodt, and Electromet. Given that the uranium had been separated from its progeny during the refining process, radiation exposures during the production of uranium metal were almost entirely due to the three naturally occurring isotopes of uranium, 234U, 235U, and 238U.
Once the immediate need for uranium metal was fulfilled, the Ames Project began to develop methods for purifying thorium in 1943. By late 1944, a large-scale process for thorium metal production was developed. Between 1950 and 1953, when thorium production was turned over to commercial operations, >65 tons of pure thorium metal and thorium compounds were produced by the Ames Laboratory (
Several steel mills contributed to the production of uranium metal rods used by Hanford as targets for the production of plutonium. Rolling of uranium metal rods was investigated at Joslyn Manufacturing and Supply during and after the war effort to evaluate methods to improve product quality and reduce losses of product during the manufacturing process. Another development that promised improvements in the production of uranium metal rods was the successful rolling of lead-dipped uranium billets by Joslyn in 1948, which, according to the early AEC reports, were far superior to the Hanford
During the late 1940s, uranium metal was delivered as billets to Simonds Saw and Steel Company, Lockport, New York, and Vulcan Crucible Steel Company, Aliquippa, Pennsylvania, where they rolled the billets into rods that were shipped to Hanford. Although it is known that other rolling mills also participated in rolling operations during this early time period, Simonds Saw and Steel became the principal manufacturer of rods as Vulcan was unable to roll the larger billets coming from Mallinckrodt. The levels of airborne uranium during these early years reached >500 times the then maximum allowable concentration of 70 dpm m−3. The distribution of air samples taken at the Simonds Saw and Steel facility is provided in
With the advent of the larger DOE owned and operated facilities, the levels of exposure were better controlled, and worker monitoring programs were established and/or expanded. At these facilities, most external exposures were reduced by about an order of magnitude over that seen in the early AWE operations. The initiation of routine bioassay sampling programs, along with more standardized methods, also provided for better documentation of internal exposure in the workplace. The variety and types of exposure, however, increased dramatically. Potential exposures now included a growing inventory of actinide elements, such as plutonium, americium, and neptunium. Furthermore, a number of new reactors were constructed that increased exposure potential to photons, neutrons, and mixed fission and activation products. To support ongoing research activities, new accelerators and cyclotrons were put in service that also added to the complexity of the exposure profile.
To complete dose reconstructions at these facilities, the Division of Compensation Analysis and Support within NIOSH has collected and reviewed thousands of historical documents related to site operations and worker/workplace monitoring practices at these facilities. When individual monitoring data are available (i.e., external badge and bioassay results), NIOSH uses these preferentially to reconstruct a worker’s dose. Absent these data, NIOSH has developed co-worker models to evaluate exposures. These co-worker models, which characterize the distribution of a worker’s facility-specific exposure potential over time, have been used to establish reasonable estimates of dose for unmonitored workers. As with AWE operations, the levels of external and internal exposures have generally decreased over time, but there are some facility-specific exceptions. While it is not possible to provide a detailed summary for all DOE facilities evaluated by NIOSH, a few sites have been chosen for discussion that are considered to be representative of the types of exposures routinely encountered in dose reconstructions at DOE production and processing facilities.
The Feed Materials Production Center located near Cincinnati, Ohio, started operation as a uranium production facility in 1952. As such, the Fernald facility in Ohio took on the role of uranium refinement that was performed previously by commercial AWE facilities. In 1952, construction also began on the gaseous diffusion plant in Piketon, Ohio, which later became known as the Portsmouth Gaseous Diffusion Plant. Uranium enrichment, which was the primary activity at Portsmouth, Ohio, began in 1954.
As with most occupational exposure datasets, the annual distribution of external doses was found to be log-normally distributed. Based on the geometric standard deviation that was calculated for each year,
External exposures at the Hanford and Oak Ridge X-10
Using the bioassay monitoring information that NIOSH has collected from a number of DOE facilities, the urinary excretion of various radionuclides has been characterized as a function of time. As they predominate the internal exposure potential at DOE facilities, the radionuclides with the most monitoring data are uranium and plutonium. As with the external monitoring data, the bioassay samples for a given time period were found to be log-normally distributed, which allows the data to be described by 50th and 84th percentile excretion rates, where the 84th percentile corresponds to the excretion at one geometric standard deviation. To date, NIOSH has used these data to develop coworker exposure models at a dozen facilities. While it is not possible to discuss all these facilities during this publication, an example of a site with uranium and plutonium excretion curves is provided.
For the purposes of NIOSH’s role under EEOICPA, missed dose is defined as the potential dose that could have been received by a person who wore a personal monitoring badge or submitted a bioassay sample, but because of technical limitations, the dose was undetected.
In all cases processed by NIOSH, missed dose is explicitly included in the external and internal dose reconstructions (
The assumptions described above lead to the assignment of dose to workers that could far exceed their recorded workplace exposure. Specifically, this would be most notable in cases where the dose to the lung was being reconstructed and, to a lesser extent, to one of the organs that tend to concentrate actinides (e.g., the liver for plutonium). For lung cancer cases especially, the missed doses assigned to workers are of sufficient magnitude to produce a probability of causation of ≥50%, even when there is no evidence of a positive bioassay sample.
Given the characteristics of the exposures described above, it is of interest to examine the overall compensation rate for the cases reconstructed by NIOSH thus far, as well as the rate for various types of cancers. As provided in
Of the 22,233 cases with a single primary cancer, lung, prostate, and skin cancer make up >50% of the cases. Lung cancer has the highest compensation rate with 2,940 dose reconstructions out of 4,521 (65%), producing a probability of causation >50%. As discussed in the previous section, this is largely a result of the missed internal dose assigned by NIOSH for cases that had the potential for inhalation exposure to the plutonium or uranium. Three forms of leukemia have three of the top six cancer compensation rates, which are primarily related to the elevated excess relative risk per Sievert associated with leukemia as compared to other solid tumors. Cancers of organs with low uptakes of actinides (e.g., brain and digestive tract) have relatively low, but not zero, compensation rates. For these cancers to be compensated, it usually requires a fairly high cumulative external exposure to penetrating gamma radiation. These types of conditions were more predominant in the early AWE periods during the processing of uranium ores.
Under the EEOICPA, NIOSH has received from the DOL >39,000 cases for dose reconstruction. The dose reconstructions performed by NIOSH are used by DOL to determine if a worker’s cancer was at least as likely as not (i.e., a probability of causation of ≥50%) caused by their exposure to ionizing radiation while employed at a DOE or AWE facility. To conduct these dose reconstructions, NIOSH has collected large amounts of information on the exposure conditions at over 200 different facilities. The exposures covered under EEOICPA span a considerable time period, beginning with the creation of the MED in 1942 and continuing through the present. Given the wide variety of operations associated with the production of nuclear weapons, the radiation source term consists of a wide range of internal and external exposure. Based on past dose reconstruction experience, the exposures that provide a large amount of dose to many claims are the external exposure in the early years (both actual and missed dose) and the internal exposure associated with the inhalation of uranium and plutonium (both actual and missed dose).
The uranium processing operations during the MED and early AEC time periods produced high internal and external exposures that were many times greater than those currently allowed under existing regulations. In addition to uranium, workers in this era were also exposed to high levels of radon gas and uranium progeny, including 226Ra and 230Th. Over time, these exposures were reduced greatly due to improvements in administrative and engineering controls. At the same time, the introduction of reactors and chemical processing plants increased the variety of the source term.
Over time, large purpose-built DOE facilities were constructed. These facilities established monitoring programs that included the routine issuance of external dosimeter badges and collection of bioassay samples. An evaluation of the data collected over time allows for the characterization of internal and external exposures at these facilities. Several examples provided in this presentation demonstrate the overall trend in the reduction of exposures over time, with deviations in this pattern related to site-specific activities.
By including missed dose and using other favorable assumptions, almost 30% of all claims have dose reconstructions that result in a probability of causation ≥50%. Incorporation of missed dose into lung cancer cases results in a compensation rate of more than two times that of the average.
Because this paper recounts historical exposures to workers over an extended period of time, the traditional units employed at the time the measurements were made are reported.
At facilities where it has been determined that dose reconstructions cannot be performed with sufficient accuracy, EEOICPA provides for the addition of certain classes of workers to a Special Exposure Cohort. For those classes of workers added to the Special Exposure Cohort, dose reconstructions are not required, and causation is presumed, for any of the 22 cancers prescribed in the Act.
Site operations at the Oak Ridge X-10 facility began in 1943. Much of the early site work was devoted to the development and operation of the original plutonium production reactor and associated chemical separation facility to test the larger production reactors that were being built on the Hanford Site.
This value is based on 31,467 claims with a single primary cancer and with dose reconstructions approved and submitted to DOL through 21 September 2012.
Construction of the Hanford Site, located in Richland, Washington, began in 1943. The Hanford Site played an important role in the development of the U.S. nuclear weapons program. Operations at the site included the construction of nine reactors to produce plutonium for weapons and seven physical testing, research, and demonstration reactors. Facilities for the separation of uranium and plutonium, for uranium and tritium extraction, and for many support functions evolved over the years.
The author declares no conflicts of interest.
Supplemental Digital Content is available in the HTML and PDF versions of this article on the journal’s Web site (
Distribution of DOE facility cases by site.
Distribution of employment start dates for cases received.
Gross alpha air concentration at early uranium refining facilities.
Distribution of air samples at Simonds Saw and Steel, 1948.
50th percentile external gamma doses as measured by personnel dosimeters (includes missed dose).
95th percentile external gamma doses as measured by personnel dosimeters (includes missed dose).
50th percentile external gamma doses as measured by personnel dosimeters (includes missed dose).
95th percentile external gamma doses as measured by personnel dosimeters (includes missed dose).
Measured 239Pu excretion in urine at Hanford.
Measured uranium excretion in urine at Fernald.
Weapons production activities that created an exposure potential.
| Uranium milling and refining | Chemical separations |
| Enrichment | Weapons fabrication |
| Metal fabrication | Weapons operations |
| Reactor operations | Research and development |
Types of exposures associated with weapons production activities.
Gamma Beta Neutron Medical x-rays |
Uranium (depleted, natural, and enriched) Thorium Uranium and thorium progeny Plutonium Other actinides (e.g., americium and curium) Mixed fission and activation products |
External gamma exposures — Mallinckrodt Chemical Works.
| Year | Annual exposure (R)
| ||
|---|---|---|---|
| Minimum | Average | Maximum | |
| 1947 | 14.4 | 16.1 | 23.5 |
| 1948 | 14.9 | 17.0 | 20.3 |
| 1949 | 7.7 | 9.0 | 13.3 |
| 1950 | 4.5 | 5.4 | 7.1 |
| 1951 | 5.0 | 5.9 | 7.1 |
| 1952 | 5.1 | 5.9 | 6.6 |
| 1953 | 4.0 | 4.6 | 5.7 |
| 1954 | 3.9 | 4.4 | 5.1 |
| 1955 | 3.9 | 4.4 | 5.1 |
| 1956 | 1.1 | 1.4 | 1.9 |
Reported radon levels — Mallinckrodt Chemical Works (1949–1957).
| Location | Median (pCi L−1) | Geometric standard deviation | 95th percentile (pCi L−1) |
|---|---|---|---|
| Plant 6 | 3–19 | 3–7 | 59–244 |
| Ore filtration areas | 4–35 | 2–10 | 33–1,012 |
| K-65 centrifuge | 3–13 | 2–8 | 24–192 |
| Ore storage | 1–26 | 4–22 | 41–590 |
| Scale house | 1–59 | 3–8 | 10–680 |
Compensation results by the NIOSH Interactive Radio Epidemiology Program (IREP) cancer model based on claims with dose reconstruction approval and submitted to DOL through 21 September 2012 (31,467 claims).
| Rank by compensation rate | NIOSH-IREP cancer model (ICD-9 code)
| Compensated (PC ≥ 50%)
| Not compensated (PC < 50%)
| Total claims
| |||
|---|---|---|---|---|---|---|---|
| Claims with a single primary cancer | % | % | % | ||||
| 1 | Lung (162) | 2,940 | 65.0 | 1,581 | 35.0 | 4,521 | 20.3 |
| 2 | Chronic myeloid leukemia (205.1) | 48 | 53.3 | 42 | 46.7 | 90 | 0.4 |
| 3 | Non-melanoma skin—basal cell (173) | 947 | 52.8 | 846 | 47.2 | 1,793 | 8.1 |
| 4 | Acute lymphocytic leukemia (204.0) | 41 | 50.0 | 41 | 50.0 | 82 | 0.4 |
| 5 | Liver (155.0) | 75 | 43.1 | 99 | 56.9 | 174 | 0.8 |
| 6 | Acute myeloid leukemia (205.0) | 73 | 37.4 | 122 | 62.6 | 195 | 0.9 |
| 7 | Lymphoma and multiple myeloma (200–203) | 626 | 36.9 | 1,071 | 63.1 | 1,697 | 7.6 |
| 8 | Malignant melanoma (172) | 226 | 35.4 | 412 | 64.6 | 638 | 2.9 |
| 9 | Other respiratory (160, 161, 163–165) | 186 | 30.4 | 426 | 69.6 | 612 | 2.8 |
| 10 | Leukemia, excluding chronic lymphocytic leukemia (204–208, excluding 204.1) | 42 | 30.2 | 97 | 69.8 | 139 | 0.6 |
| 11 | Oral cavity and pharynx (140–149) | 98 | 22.1 | 346 | 77.9 | 444 | 2.0 |
| 12 | Bone (170) | 41 | 18.3 | 183 | 81.7 | 224 | 1.0 |
| 13 | Thyroid (193) | 52 | 16.5 | 264 | 83.5 | 316 | 1.4 |
| 14 | Gallbladder (155.1, 156) | 17 | 15.2 | 95 | 84.8 | 112 | 0.5 |
| 15 | Eye (190) | 5 | 9.8 | 46 | 90.2 | 51 | 0.2 |
| 16 | Stomach (151) | 49 | 9.3 | 479 | 90.7 | 528 | 2.4 |
| 17 | Colon (153) | 91 | 7.5 | 1,116 | 92.5 | 1,207 | 5.4 |
| 18 | Urinary organs, excluding bladder (189) | 41 | 6.8 | 559 | 93.2 | 600 | 2.7 |
| 19 | Bladder (188) | 41 | 6.7 | 570 | 93.3 | 611 | 2.7 |
| 20 | Other endocrine glands (194) | 1 | 3.7 | 26 | 96.3 | 27 | 0.1 |
| 21 | All male genitalia (185–187) | 136 | 3.2 | 4,177 | 96.8 | 4,313 | 19.4 |
| 22 | Esophagus (150) | 4 | 2.9 | 136 | 97.1 | 140 | 0.6 |
| 23 | Connective tissue (171) | 4 | 2.8 | 137 | 97.2 | 141 | 0.6 |
| 24 | All digestive (150–159) | 3 | 2.7 | 108 | 97.3 | 111 | 0.5 |
| 25 | Other and ill-defined sites (195) | 1 | 1.9 | 51 | 98.1 | 52 | 0.2 |
| 26 | Breast (174–175) | 16 | 1.8 | 897 | 98.2 | 913 | 4.1 |
| 27 | Non-melanoma skin–squamous cell (173) | 11 | 1.7 | 622 | 98.3 | 633 | 2.8 |
| 28 | Pancreas (157) | 5 | 0.9 | 575 | 99.1 | 580 | 2.6 |
| 29 | Rectum (154) | 3 | 0.6 | 516 | 99.4 | 519 | 2.3 |
| 30 | Nervous system (191–192) | 1 | 0.2 | 414 | 99.8 | 415 | 1.9 |
| 31 | Female genitalia, excluding ovary (179) | 0 | 0.0 | 242 | 100.0 | 242 | 1.1 |
| 32 | Ovary (183) | 0 | 0.0 | 113 | 100.0 | 113 | 0.5 |
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