available for use in dose reconstructions at least since 1994 (see Section V.C.3.2, comments [1] and [2]). The conclusion that the upper bound of a dose coefficient for inhalation could be underestimated by a factor of more than 10 in the worst cases takes into account the presumed bias of most dose coefficients used in dose reconstructions to overestimate dose when a particle size (AMAD) of 1 μm is assumed (see Tables V.C.1 and V.C.2).

The substantial uncertainty in dose coefficients is important because it affects all calculations of inhalation dose to participants. Uncertainty in dose coefficients should be acknowledged and taken into account in the NTPR program if credible upper bounds of inhalation doses to atomic veterans are to be obtained.

V.C.6 Conclusions on Credibility of Estimated Upper Bounds of Inhalation Dose

All estimates of inhalation dose to atomic veterans obtained in the NTPR program are reported as single values without uncertainty, and those estimates are intended to provide upper bounds of possible inhalation doses. Thus, the key question in evaluating methods of estimating inhalation doses used in dose reconstructions is whether the methods provide credible upper bounds. If they do, estimates of inhalation dose to atomic veterans are appropriate for use in evaluating claims for compensation for radiation-related diseases. However, if estimates of inhalation dose are substantially less than credible upper bounds, the veterans are not given the benefit of the doubt and, depending on the magnitude of possible doses from all exposure pathways, their claims for compensation may not be evaluated fairly; that is, a veteran’s claim could be denied even though a credible upper-bound estimate of dose, taking all exposure pathways and uncertainties into account, would qualify the veteran for compensation.

As discussed in Section V.C.3.3, the committee does not believe that the question of whether estimates of inhalation dose obtained in the NTPR program are credible upper bounds can be given a single answer that applies to all exposure scenarios for participants at the NTS and in the Pacific. However, partly on the basis of conclusions obtained in previous reviews by committees of the National Research Council (see Section V.C.2), the NTPR program has often claimed that its methods of calculating inhalation dose provide overestimates of dose (the doses are “high-sided”), the implication being that the claim applies generally (see, for example, Schaeffer, 2001b). Therefore, the question is whether the methods of estimating inhalation doses provide credible upper bounds in all or nearly all cases.

The present committee’s review of methods of estimating inhalation dose used in the NTPR program has been considerably more extensive than previous reviews by other committees of the National Research Council. The present committee considered many issues involved in estimating inhalation doses that were not evidently considered in previous reviews. Furthermore, the present committee had

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