The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: study of errors in dosimetry.

To provide direct estimates of cancer risk after low-dose protracted exposure to ionizing radiation, a large-scale epidemiological study of nuclear industry workers was conducted in 15 countries. As part of this study, identification and quantification of errors in historical recorded doses was conducted based on a review of dosimetric practices and technologies in participating facilities. The main sources of errors on doses from "high-energy" photons (100-3000 keV) were identified as the response of dosimeters in workplace exposure conditions and historical calibration practices. Errors related to dosimetry technology and radiation fields were quantified to derive period- and facility-specific estimates of bias and uncertainties in recorded doses. This was based on (1) an evaluation of predominant workplace radiation from measurement studies and dosimetry expert assessment and (2) an estimation of the energy and geometry response of dosimeters used historically in study facilities. Coefficients were derived to convert recorded doses to H(p) (10) and organ dose, taking into account different aspects of the calibration procedures. A parametric, lognormal error structure model was developed to describe errors in doses as a function of facility and time period. Doses from other radiation types, particularly neutrons and radionuclide intake, could not be adequately reconstructed in the framework of the 15-Country Study. Workers with substantial doses from these radiation types were therefore identified and excluded from analyses. Doses from "lower-energy" photons (<100 keV) and from "higher-energy" photons (>3 MeV) were estimated to be small.

Mayak film dosimeter response studies, part I: measurements.

The Mayak Worker Dosimetry study is a joint Russian/U.S. project to evaluate doses received by workers at the Mayak Production Association facilities from 1948-1972. A key investigation in this project is the characterization of responses of the three types of film dosimeters used to monitor workers during this time period. Experimental irradiations of the dosimeters were performed in the radiation calibration laboratories at the National Research Center for Environment and Health (GSF) in Munich, Germany. The irradiations used photon sources from x-ray beams with ten different energy distributions and with Co and Cs isotopic gamma sources. Irradiations were performed with the dosimeters on phantoms and free-in-air. The dosimeters and phantoms were also positioned at varying angles to the radiation beam. The result of the experiments was a thorough characterization of the dosimeter response as a function of photon energy and as a function of angle for energy and angular ranges that cover the conditions encountered in the Mayak workplaces. The characterization data were then available for use in developing correction factors, which could be applied to worker dosimeter readings to provide a more accurate assessment of worker dose and estimates of doses to organs.

Mayak film dosimeter response studies, part II: response models.

A study was performed of energy and angular responses of the film dosimeters that were used for worker monitoring at the Mayak Production Association (Mayak PA) in 1948-1992. The study used experimental data from tests with three types of individual film dosimeters, and the data were used to determine the dosimeters' energy and angular response characteristics in the range from 9 keV to Co energies, with the dosimeters exposed both free-in-air and on-phantom at horizontal and vertical rotation. Mathematical models of the dosimeters were developed to calculate the response characteristics of the dosimeters. The models of the film dosimeters were validated by comparing calculations to measurements. The models were then used as the basis for individual dose reconstruction in realistic photon spectra and worker exposure geometries at the Mayak PA workplaces. Reconstructed individual doses have been included in the Mayak worker database "Doses-2005" that is used for epidemiological studies of the Mayak workers' radiation exposures and subsequent health effects.

Mayak worker dosimetry study: an overview.

The Mayak Production Association (MPA) was the first plutonium production plant in the former Soviet Union. Workers at the MPA were exposed to relatively large internal radiation intakes and external radiation exposures, particularly in the early years of plant operations. This paper describes the updated dosimetry database, "Doses-2005." Doses-2005 represents a significant improvement in the determination of absorbed organ dose from external radiation and plutonium intake for the original cohort of 18,831 Mayak workers. The methods of dose reconstruction of absorbed organ doses from external radiation uses: 1) archive records of measured dose and worker exposure history, 2) measured energy and directional response characteristics of historical Mayak film dosimeters, and 3) calculated dose conversion factors for Mayak Study-defined exposure scenarios using Monte Carlo techniques. The methods of dose reconstruction for plutonium intake uses two revised models developed from empirical data derived from bioassay and autopsy cases and/or updates from prevailing or emerging International Commission on Radiological Protection models. Other sources of potential significant exposure to workers such as medical diagnostic x-rays, ambient onsite external radiation, neutron radiation, intake of airborne effluent, and intake of nuclides other than plutonium were evaluated to determine their impact on the dose estimates.

External dose estimation for nuclear worker studies.

Epidemiological studies of nuclear workers are an important source of direct information on the health effects of exposure to radiation at low doses and low dose rates. These studies have the important advantage of doses that have been measured objectively through the use of personal dosimeters. However, to make valid comparisons of worker-based estimates with those obtained from data on A-bomb survivors or persons exposed for medical reasons, attention must be given to potential biases and uncertainties in dose estimates. This paper discusses sources of error in worker dose estimates and describes efforts that have been made to quantify these errors. Of particular importance is the extensive study of errors in dosimetry that was conducted as part of a large collaborative study of nuclear workers in 15 countries being coordinated by the International Agency for Research on Cancer. The study, which focused on workers whose dose was primarily from penetrating gamma radiation in the range 100 keV to 3 MeV, included (1) obtaining information on dosimetry practices and radiation characteristics through the use of questionnaires; (2) two detailed studies of exposure conditions, one of nuclear power plants and the other of mixed activity facilities; and (3) a study of dosimeter response characteristics that included laboratory testing of 10 dosimeter designs commonly used historically. Based on these efforts, facility- and calendar year-specific adjustment factors have been developed, which will allow risks to be expressed as functions of organ doses with reasonable confidence.

Accounting for bias in dose estimates in analyses of data from nuclear worker mortality studies.

Although dose estimates used in epidemiologic studies of nuclear workers are far superior to exposure measures used in many epidemiologic studies, they are subject to several types of bias. These include bias resulting from practices used to measure and record very low doses and from underestimation of dose from neutrons. They also include bias resulting because available dose estimates do not include dose from internally deposited radionuclides, occupational dose received after workers have terminated employment at the facility of interest, or dose from background or medical exposures. These biases can potentially distort dose-response analyses and lead to biased risk estimates and confidence limits. This paper uses data on workers at the Hanford site to investigate the possible effects of these biases on dose-response analyses of leukemia and of all cancer except leukemia. This is accomplished by conducting analyses based on a variety of assumptions regarding the nature and magnitude of these biases. Results were not modified greatly (as compared to those based on the dose as recorded) for any of the 40 sensitivity analyses presented, including some based on fairly extreme assumptions. However, analyses that excluded workers with potential for dose from internal depositions and from neutrons did increase both the risk estimate and upper confidence limits; it may be desirable to emphasize this approach in future presentations. It is recommended that similar sensitivity analyses be performed with data from other worker studies, addressing the specific dosimetry problems that have been identified in those populations.

An approach to evaluating bias and uncertainty in estimates of external dose obtained from personal dosimeters.

This paper describes an approach to quantifying errors in recorded estimates of external radiation dose obtained from personal dosimeters and applies the approach to dose estimates of workers at the Hanford site. Because a major objective of this evaluation is to provide the information needed for adjusting epidemiologic dose-response analyses of worker data for errors in dose estimates, the paper addresses the extent that errors for different workers are correlated, focuses on recorded doses as estimates of organ doses, and focuses on recorded doses as estimates of organ doses, and gives consideration to both annual and cumulative doses. The evaluation emphasizes errors resulting from the fact that dosimeters are limited in their ability to respond accurately to all radiation energies to which workers are exposed or to radiation coming from all directions. For each of several sources of error, systematic bias factors are estimated for two energy ranges (100--300 keV and 300--1,000 keV), two geometries (anterior-posterior and rotational), and four calendar year periods. These are then combined using information provided by health physicists on energies and geometries in Hanford exposure environments. Except for the period before 1958, deep dose, the objective of modern dosimetry systems, was found to be fairly accurately estimated. Lung dose was found to be overestimated by about 10%, and bone marrow dose was found to be overestimated by about 50%. However, many aspects of this evaluation relied heavily on subjective judgments, and, thus, these factors are subject to considerable uncertainty. Estimates of uncertainty in the bias factors and uncertainty reflecting random error are provided.