1. Radiation Exposure of the U. S. Population Kenneth R. Kase Sr. Vice President and Chair of Scientific Committee 6-2 Kenneth L. Miller, Dennis M. Quinn Daniel J. Strom, Orhan H. Suleiman Bruce R. Thomadsen, Marvin Rosenstein Subcommittee Chairs & Staff Health Physics Society Annual Meeting American Academy of Health Physics July 2009 1

2. Natural Background  Daniel J. Strom  Alan Birchall  Thomas B. Borak  David J. Brenner  Paul E. Goldhagen  Keran O’Brien III  Jerome S. Puskin  Thomas F. Gesell*  Anthony James* * Consultants Medical Patient  Bruce R. Thomadsen  Mythreyi Bhargavan  Debbie B. Gilley  Joel E. Gray  Jill A. Lipoti  Mahadevappa Mahesh  John L. McCrohan  Fred A. Mettler, Jr.  Terry T. Yoshizumi 2

3. Consumer Products  Orhan H. Suleiman  Jennifer Goodman  Raymond H. Johnson, Jr.  Cheryl K. Rogers  Paul W. Frame*  Ronald L. Kathren* Industrial  Dennis M. Quinn  Ralph Andersen  Regis A. Greenwood  Cynthia G. Jones *Consultants Occupational Exposure  Kenneth L. Miller  David J. Allard  Kelly Classic  Michael A. Lewandowski  Kathleen L. Shingleton  George J. Vargo Sources  E. Scott Medling  Carl J. Paperiello  Linda M. Sewell 3

4.  Overview of Report  Exposure from Ubiquitous Natural Background, including Radon  Exposure to Patients from Medical Procedures  Exposure from Consumer Products and Activities  Exposure from Industrial, Security, Medical, Educational and Research Activities  Occupational Exposure  Summary 4

5.  NCRP Report No. 93: Exposure of the U.S. population to ionizing radiation as of the early 1980s.  Population dose has increased because the population has increased, but  Individual dose has also increased from medical procedures to exposed individuals;  Individual and population doses from various other sources have changed. 5

6.  Results are presented as annual values for:  average effective dose to an individual in a group exposed to a specific source ( E Exp ) (mSv);  collective effective dose ( S ) (person-Sv);  and effective dose per individual in the U.S. population ( E US ) (mSv).  Variation of dose and uncertainties in dose are discussed.  Doses reported are not suitable for use in risk assessment. 6

7.  Four subcategories grouped by the origin of the source:  external exposure from space radiation (solar particles and cosmic rays);  external exposure from terrestrial radiation (primarily from 40 K and the 238 U and 232 Th decay series);  internal exposure from inhalation of radon and its progeny;  and internal exposure from radionuclides in the body (primarily 40 K). 7

8. 8

9. 9 Annual Effective Dose = 0.21 mSv

10. 10 Concentration University of Pittsburgh LBNLEPA (Bq m –3 )(States)(Counties)(States)(Counties)(Regions)(Residences) Arithmetic mean59.865.556.659.149.546.3 Standard deviation 25.437.831.639.425.2 Standard error of the mean 4.4 Minimum22.19.713.16.321.1 Maximum11623714126695.8 Number461,601493,079105,694

11.  For indoor exposure an average concentration in U.S. residences of 46.3 Bq m  3 is used.  The average annual potential alpha energy exposure is estimated to be 0.207 WLM.  Over 40 calculations of dose conversion coefficients show a lognormal distribution with an arithmetic mean of 10 mSv WLM −1 and a standard deviation of 5 mSv WLM −1.  The average adult in the United States receives an annual effective dose to the bronchial epithelium of 2.07 mSv 11

12.  Annual Effective Dose:  From Rn-222 decay products = 2.07 mSv  From Rn-222 gas = 0.05 mSv  From Rn-220 gas & decay products = 0.16 mSv  Total Annual Effective Dose from radon 2.3 mSv 12

13.  Annual Effective Dose from K-40  Males – 0.149 (0.069 – 0.243) mSv  Females – 0.123 (0.067 – 0.203) mSv  Avg., male & female – 0.136 mSv  Annual Effective Dose from Th-232, U-238  Avg., male & female – 0.127 (0.050 – 0.138) mSv  Infants – 0.132 mSv; children – 0.114 mSv  Others (C-14, Rb-87) – 0.01 mSv  Total Annual Effective Dose 0.28 mSv 13

14. SourceAMSDPercentiles (mSv) 2.597.5 Space0.330.080.200.52 Terrestrial0.210.060.120.35 Radon-2222.123.990.0911.1 Radon -2200.160.310.0070.80 Internal – K-400.140.020.110.21 Internal – U & Th0.130.0070.110.14 Internal – Others (C-14, Rb-87) 0.01 TOTAL3.103.610.9412.1 14

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16.  Five subcategories grouped by type of medical modality:  computed tomography;  conventional radiography and fluoroscopy;  interventional fluoroscopy;  nuclear medicine; and  Radiotherapy (results were not included in the total because of unique considerations). 16

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18. CategoryRange of Effective Dose (mSv) Effective Dose per Scan (mSv) Head0.9 – 42 Abdomen & pelvis3 – 2510 Extremity0.1 - 10.1 Virtual colonography5 – 1510 Whole-body screening5 – 1510 Calcium scoring1 – 122 Angiography – Head1 – 105 Angiography – Heart5 – 3220 Other1 - 105 18

19. CategoriesScans (%) S (person-Sv) S (%) Head28.438,0448.7 Chest15.974,32617.0 Abdomen/pelvis31.7212,53848.6 Extremity5.25150.1 Angio – Heart3.446,00010.5 Angio – Head3.010,0002.3 Spine6.241,3699.5 Interventional3.42300.5 Cardiac0.56,0001.4 Others2.58,5002.0 19

20.  Total Annual Collective Effective Dose (S): 437,500 person Sv 20

21. ExaminationE per Exam (mSv) No. Exams (÷ 1000) S (person-Sv) S (%) Chest0.1128,94412,89412.8 Breast0.18 (0.42)34,5006,210 (14,490)6.2 Cervical Spine0.25,8001,1601.2 Thoracic Spine1.02,590 2.6 Lumbar Spine1.511,19716,79616.7 Upper GI6.04,04424,26424.1 Abdomen0.714,96410,47510.4 Barium Enema8.06565,2485.2 IVP3.01,1803,5403.5 Pelvis & Hip0.6 – 0.719,96313,15613.1 Other exams0.005 – 1.758,1311,6130.7 Dental0.005 (0.21)500,0002,528 (10,500)2.8 21

22.  Annual Collective Effective Dose (S) : 100,500 person Sv (116,800 person-Sv using ICRP 2007 weighting factors for breast and dental exposures) 22

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24.  Total number of procedures: 16,735,650  Annual Collective Effective Dose (S): 128,400 person-Sv 24

25. 25 Change in Nuclear Medicine Procedures 0 10 20 30 40 50 60 Bone Cardiac Lung Thyroid Renal GI Brain Infection Tumor Other Procedure Percent of Total 1973 1982 2005

26. 26 Nuclear medicine: Age distribution, 2003 Relative to the US population age distribution 0% 5% 10% 15% 20% 25% 0-1011-1718-2425-3435-4445-5455-6465-7475-8485 and older % of procedures% of population

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28.  Total number of procedures: 18,100,000  Annual Collective Effective Dose: 231,000 person-Sv 28

29. 29 Treatment SiteNo. PatientsEffective Dose (mSv) S (person-Sv) Breast212,55833771,632 Prostate197,865949187,774 Lung134,19618725,095 Head & Neck69,54731922,185 Colorectal57,79225814,910 Gynecological52,89524012,695 Brain Metastasis48,977291,420 Brain Primary39,181592,312 GI35,2632338,216 Lymphoma, Leukemia 23,5093337,828

30.  Total number of patients: 872,000  Annual collective effective dose: 354,000 person-Sv  Effective dose per patient: 406 mSv 30

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32.  Eight subcategories grouped by the origin of the source:  cigarette smoking,  building materials,  commercial air travel,  mining and agriculture,  combustion of fossil fuels,  domestic water supplies,  highway and road construction materials, and  glass and ceramics. 32

33.  Potential sources that are not discussed further in this Report (refer to NCRP, 1987d, Table 5.1) include:  Dental prostheses  Opthalmic glass  Luminous watches and clocks  Gas and aerosol (smoke) detectors  Electron tubes  Thorium products (including gas mantles and welding rods). 33

34. Annual effective dose ( μ Sv) for one cigarette per day. Reference 226 Ra 228 Ra 210 Pb 210 PoRangeAvg 1.3–6.70.6–3.31.7–4.3 5.0–13.38.3Papastefanou 6.0–208.0Prerez et al 3.51.7Skwarzec et al 7.5–2516.3Desideri et al 20–3527.5Khater et al 30Guilmette ____ 18Overall Avg 34

35. Annual collective effective dose Cigarettes (per day) Avg E per Smoker (mSv) Smokers (millions) S (person-Sv) Men180.32 (0.09 – 0.6) 25 8,100 (2,250 – 15,000) Women150.27 (0.08 – 0.5) 20 5,400 (1,600 – 10,000) Total 13,500 (~14,000) 35

36.  Analyzed the dose from the use of coal combustion products in buildings – similar to dose from brick & masonry  Assumed that the radiation dose to individuals living in brick and masonry buildings has not changed since the estimates made in the 1980s  Assumed that 50 % of population lives in brick and masonry buildings  Use of zircon glazed tiles and fixtures, granite countertops, desktops, wall and floor tiles, and marble could add a small additional collective dose 36

37.  Annual collective effective dose: 10,500 person-Sv 37

38.  Domestic:  660.7 million passengers  Average dose rate - 3.30 μ Sv per air hour (SD = 1.81 µSv/h)  Average air time - 2.84 h.  International:  84.8 million passengers on U. S. carriers  Average dose rate - 5.21 μ Sv per air hour (SD = 0.94 μ Sv/h)  Average air time - 9.35 h. 38

39.  Annual collective effective dose: 10,300 person-Sv 39

40. SourceExposed (millions) E Exp ( μ Sv) S (person-Sv) Mining and agriculture250102,500 Combustion of fossil fuels Natural gas cooking1554620 Coal3001 Road construction materials 640240 Glass and ceramics<10 Other sources1,000 Total39,000 40 Other Sources include: dental prostheses, opthalmic glass, luminous watches and clocks, gas and aerosol (smoke) detectors, electron tubes, and thorium products (including gas mantles and welding rods).

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42.  Six subcategories grouped by activity and associated type of source:  nuclear medicine patients;  nuclear power generation;  industrial, medical, educational and research activities;  DOE installations;  decommissioning and radioactive waste;  security imaging systems. 42

43.  Procedures performed: 8 million  Persons (family and coworkers) exposed during each procedure:4  Effective dose per procedure (NCRP Report No. 124, 1996): 10 μ Sv  Annual collective effective dose: 720 person-Sv 43

44. Annual collective H E to the regional population normalized to a 1 GWe reactor operating at full capacity 80 % of the time FacilityAnnual Collective H E (person-Sv) Mining0.94 Milling0.25 Conversion0.0003 Enrichment0.0001 Fabrication0.00004 Nuclear Power Plants0.048 Transportation0.125 Total per 0.8 GW e 1.36 44

45.  Operating nuclear power plants in the U S: 104  Installed capacity: 100 Gwe  Capacity factor: 89.6 %  Power generation: 90 GWe  Annual collective effective dose: 153 person-Sv 45

46. SourceEstimate of Exposed Population Avg. Dose per Person (mSv) Collective Effective Dose (person-Sv) Medical – Occupational 740,0000.8550 Public74,000,0000.0016120 Industry and Commerce – Occupational 130,0000.8110 Public1,300,0000.0023 Education and Research – Occupational 84,0000.760 Public840,0000.00182 Total S125 46

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48.  Six subcategories grouped by the nature of employment and associated type of source:  medical;  aviation;  commercial nuclear power;  industry and commerce;  education and research; and  government, DOE and military. 48

49. Numbers of Workers and Doses 2003200420052006 Monitored workers1,957,0882,220,8612,352,9762,519,693 Workers with recordable dose 690,661735,400693,941735,347 Collective effective dose (person-Sv) 508559546549 Average effective dose (mSv) 0.740.760.790.75 49

50. 50 Numbers of Workers and Doses 2003200420052006 Monitored airline crew0000 Number of airline crew177,000180,000176,000173,000 Collective effective dose (person-Sv) 543553540531 Average effective dose (mSv) 3.07

51. 51 Numbers of Workers and Doses 2003200420052006 Monitored workers109,990110,290114,344116,354 Workers with recordable dose 55,96752,87357,56658,788 Collective effective dose (person-Sv) 120104115110 Average effective dose (mSv) 2.141.972.001.87

52. 52 Numbers of Workers and Doses 2003200420052006 Monitored workers360,069556,325579,864505,369 Workers with recordable dose 112,671133,926125,257134,105 Collective effective dose (person-Sv) 98114117109 Average effective dose (mSv) 0.870.850.930.81

53. 53 Numbers of Workers and Doses 2003200420052006 Monitored workers351,309504,948514,267437,007 Workers with recordable dose 79,90188,12581,73283,700 Collective effective dose (person-Sv) 43735160 Average effective dose (mSv) 0.540.830.620.72

54. 54 Numbers of Workers and Doses 2003200420052006 Monitored workers265,870289,979301,498284,192 Workers with recordable dose 36,55936,78833,93430,591 Collective effective dose (person-Sv) 44493839 Average effective dose (mSv) 0.660.730.500.59

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56. Exposure Category S (person-Sv) E US (mSv) E Exp (mSv) Background933,0003.11 0.94 – 12.1 Medical899,0003.00 Consumer, etc. 39,0000.13 0.001 - 0.4 Industrial, etc. 1,0000.003 0.001 - 0.01 Occupational1,4000.005 <1 - 30 56

57.  Collective Effective Dose 1,870,000 person-Sv  Individual Effective Dose 6.2 mSv 57

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