permitted to resume his work as an X-ray technician. His blood picture neither represents the effect of radiation nor does it make him any more liable to X-ray damage than the next person. The hematologist also reported at that time that claimant’s past medications CASE NO. 43 Type ofInjury: Leukopenia and Lymphocytic Leukemia. BEC's Decision: Compensation Granted. Date of Decision: 197}. Claimant’s 1 Allegation: That het husband’s death was causall i occupational exposure to radiation prior to 1962. wy Felated to Ris Facts: The decedent was a X-ray technician at a gover nmen i i records indicated he had been a hospital attendant for about ieven wh October 1946 he filed a claim for tuberculosis which was accepted by the Bureau. The tuberculosis was treated by pneumoperitonium procedures without drugs. During the period of treatment he had multiple X-ray exposure made in connection with a fracture of the femur . Claimant’s medical histor further showed that he was hospitalized in 1958 for acute maxillary sinusitis and bronchial pneumonia. Just prior to admis sion he had been treated for the sinusitis with chloromyce tin one gm. four times a day. In 1961 he was hospitalized because of a four year histor y of leukopenia with the white count ranging between 3,000 and 3,300, a marke d depression of neutrophils and a relative lymphocytosis. A bone marrow done at that time was non-specific. In 1962 the decendent filed a claim alleging that his persistent low blood count was the result of occupational exposure. By 1962 claimant had worked as an X-ray techni cian for about sixteen years, both while in the armed services and as a civilian, Radiation exposure records from 1956 to 1961 showed I rem with a minum exposure in 1960 of .99 roent gen, equivalent to approximately 990 included occasional polaramine, achromycin, and declomycin but that “He never received chloromycetin, any of the chlorothiazide, anti-thyroid, antiepileptic treatment.” He further stated: There is an infiltrate in his marrow of mononuclear cells that resemble lymphocytes. They do not look particularly malignant or granulomatous. The exact diagnosis is uncertain at this time. The radiation expert offered the following opinion: The film badges indicate a total exposure of 4.1 1 in 5S years. Supposing total body exposure and moderately penetrating radiation this would give an average absorbed dose of about 1.3 rads—an integral dose of nearly a tenth of a megagram rad. The average absorbed doses from his diagnostic radiography plus the fluoroscopies give a total integral dose of about two megagram rads in sixteen years. In estimating the chance of harm from the claimant’s absorbed dose the radiation expert then said: The British spondylitis cases indicate doubling of the natural leukemia rate by a total absorbed dose of 7.5 megagram tads. The leukemogenesis appeared to be mostly between one and six years after exposure. Since no leukemia had appeared in the first twelve of the sixteen years observation in [claimant], it seems we should calculate recent and future chance of leukemia on only the last third of his exposures, i.¢.,on 0.7 megagram rads, If one takes a linear extrapolation, this dose-about a tenth of the doubling dose—would give 5 chances per million of leukemia (per year for 5 years) a total of 25 chances per million. Medical Evidence: A hematologist and a radiat ion expert were asked for an opinion on causation. The hematologist repor ted in July 1962 that claimant’s hematologic findings had no connection with X-ray exposure and hesaid: He further pointed out that if one thinks the leukemogenesis goes as the square of the dose, this would miean that one tenth the doubling dose would give one hundredth the natural feukerogenesis, i.e., one quarter chance in a million and he said: The blood count on July 9, 1962, was normal except for a moderate granulocytopenia. A sternal marrow aspiration obtained the ‘same day disclosed excellent overall cellularity. Howev er, the granulocyte precursors were decreased in number and the lymph ocytesincreased. No primitive, abnormal, or malignant cells were seen. There was a fair amount of marrow hemosiderin. (The radiation expert] and { have discussed A more understandable way to put it is this: If [claimant] develops leukemia, one estimates the chances ate one in ten that the X-rays were this man’s X-ray exposure and current hematologi c picture and are convinced there is no connection. We both agree that he should be 134 the cause ofit. Or, if you adopt the quadratic relationship, one chance in one hundred. The chief of radiology service at the employing hospital reported in 1962: I have carefully reviewed all the evidence on [claimant's] condition including numerous blood counts on him... It is noted that a rather 135