bones and extremities which contain little functioning hematopoietic
bone marrow and, hence, this portion of the radiation would not be
pertinent to the question of leukemia. The total effective dose to his
hematopoietic tissue was probably less than 25 Rem.
In light of this estimate and knowledge of the experience of others
whoreceived comparable training in the Army, I doubt strongly that
sufficient radiation would have been received by functioning
hematopoietic bone marrow of the veteran while he was in the service to
cause leukemia of any type.
The assumption is reasonable that the veteran’s chronic myelogenous
leukemia might have been incurred as a result of damage to his bone
marrow from radiation received in the course of his work as a civilian
X-ray technician for 20 years. It would be sheer speculation to attempt
CASE NO. 13
Type of Injury: Myeloid Leukemia.
BVA’s Decision: Denial Affirmed.
Date ofDecision: 1969.
to say, as the veteran does, that any definite percentage could be
ascribed to his work while in the service as compared to that received as
a civilian.
Even though a reasonable doubt as to the service origin of the
Appellant's Allegation: Veteran claims he received bodily damage from
radiation received in a service X-ray school.
leukemia should be resolved in favor of the claimant, there is not in this
Facts: Veteran served from February 1946 to August 1947. During this period
he attended a 16-week X-ray technicians’ school and was assigned as an X-ray
technician at a general hospital. After his discharge from the Army the
veteran served as an X-ray technician for most of the period before he became
instance such a doubt. In view of his 20 years spent as an X-ray
technician following his Army service the additive exposures during this
long period were much more probably the cause. It will be noted that
the veteran reports that the Ohio State Industrial Commission has
approved his claim for leukemia as an occupational disease attributable
to his civilian employment of 20 years’ duration.’ My opinion concurs
with this, and 1 believe only on a basis of speculation could one assume
ill in 1966. In June 1966 he had a white blood count of 18,000 per cubic
Millimeter. He was treated with antibiotics and the WBC decreased to 11,000.
In August 1966 the WBC was again found to be elevated. In November and
December 1966 he showed persistent leukocytosis and a final diagnosis of
chronic myeloid leukemia was reported.
the exposures received during his military service to be causative.
Findings of the BVA andBasis for Decision: {n finding that service connection
for chronic myeloid leukemia is not warranted the Board said:
Medical Evidence: An independent medical expert stated:
The veteran claims that he received bodily injury from ionizing
radiation while in the Army X-ray Schoolat the age of 18 years, which
injury led to chronic myelogenous leukemia about 20 years later. He
contends that at least 50 per cent of the damage he received was
aggravated by his exposures while in the service. However, he worked for
20 years as a civilian X-ray technician. There are no records available of
the exposures to radiation received by the veteran while in the service
nor are there records of blood counts done on him at that time. Hence
one must rely on estimates of dose. Firm data are missing. He was
apperently healthy and without evidence of damage on discharge.
Although a relationship between excessive X-radiation exposure and
leukemia is known, it has not been established, with any known degree
of certainty, that the exposure to X-radiation in service was a significant
causative factor in the development of leukemia.
In addition the Board noted:
It is conceded that there is a relationship between radiation exposure
and myeloid leukemia. However, the X-radiation exposure of over 20
years’ duration cannot be disregarded. The Board is mindful of the
principle of reasonable doubt, but a careful review of the evidence and
the opinions set forth by the independent medical specialist and the
veteran’s personal physician do not afford a basis to conclude that the
exposure to radiation in service was a significantly causative factor in the
development of leukemia. To so conclude would be purely speculative.
—
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oe eee
Both in civilian and in military installations less protection against
radiation was used prior to 1954-1955 than after that period. The
possibility exists that while serving as a subject for the taking offilms
while in the X-ray Technicians School as well as in the regular work the
veteran had received some radiation. Assuming 80 kV, X- ray appliances,
as were then used, the dose measured in air might have approximated
one R per exposure, about 30 percent of which might have reached some
bone marrow cells. Moreover, this would have been partial-body
exposure, which is less effective than whole-body radiation in inducing
leukemia. A good part of his exposure would have been of the long
* The Ohio Industrial Commission allowed his claim for total permanent disability; and
upon his death in 1971 approved a death claim of his widow due to X-ray exposure
attributable to his civilian employment of 20 years duration.
51