Information in this report is required by state and federal
regulations and contains data for the NRC Form 5 and other
equivalent forms. This report is for the individual to keep. The
Radiation Safety Office keeps a copy of this report on file.
Sections of Form 5 that do not apply to a participant
will be blank. Annual Form 5 report doses are in rem ,
while monthly reports are shown in mrem. To convert Form 5
doses to mrem, multiply the dose in rem by 1000.
External dosimetry - whole body (Luxel) and extremities
(rings). Doses will be left blank when all dosimeters issued for
the year were unused or unreturned.
"ND" = not detectable. This indicates that a
dosimeter(s) was issued but did not record any dose, meaning the
dose was much lower than natural background radiation, which is
about 300 mrem per year.
||Deep Dose Equivalent (DDE) - dose at a depth
of 1 cm in tissue recorded by film badge.
||Eye Dose Equivalent To The Lens Of The Eye
(LDE) - dose at a depth of 0.3 cm in tissue (approximately the
depth of the lens of the eye) recorded by the whole body
||Shallow Dose Equivalent (SDE, WB) - dose at a
depth of 0.007 cm in tissue (the approximate thickness of the
outer protective layer of skin (stratum corneum)) recorded by the
whole body dosimeter.
||Shallow Dose Equivalent (SDE, ME) - dose at a
depth of 0.007 cm in tissue, as recorded by a ring badge (if
||Committed Effective Dose Equivalent (CEDE) -
whole body dose for the amount of radioactive material in Item
||Committed Dose Equivalent, Maximally Exposed
Organ (CDE) - largest dose to any organ from the intake.
||Total Effective Dose Equivalent (TEDE) -
internal dose and external dose combined.
||Total Organ Dose Equivalent, Max Organ (TODE)
- external "whole body" dose plus the maximum organ dose for the
internally deposited radionuclide (if applicable).
If you have questions regarding your external exposure call
the Radiation Safety Office at 206.543.0463 or email firstname.lastname@example.org .
||Contains the Landauer summary of all UW
Landauer dosimeters for all years prior to and including the
reported year. Does not include history from other employers or
Internal dosimetry - bioassay (thyroid count or
urinalysis). Evaluated for individuals working with relatively
large quantities of radioactive iodine in liquid form. Involves
thyroid counts using a sensitive detector held in front of the
neck, and measures any radioactive materials inhaled or ingested.
Unless an individual worked directly with millicurie quantities
of radioactive iodine, these sections of the form will be
||Class - an assumption about the chemical
behavior of the radioactive material inside the body.
||Mode - usually "H" (inhalation).
||Intake - an estimate of the amount of
radioactive material inhaled or ingested. (Applies only to
If you have questions regarding bioassays call the Radiation
Safety Office at 206.543.0463 or email email@example.com .
If you have any further
questions or would like an in-service presentation on radiation
safety or dosimetry service, please call the Radiation Safety
Office at 206.543.0463 or email firstname.lastname@example.org .
||Signature Licensee - The signature block is
included for NRC licensees. However, the UW is licensed through
the State of Washington. As such, this NRC Form 5 does not need
to be signed nor returned.
Occupational Dose Limits*
(Different tissues have different sensitivities, and
therefore different dose limits.)
||Annual Limit in mrem
||Annual Limit in rem
|Deep Dose Equivalent
|Lens Dose Equivalent
|Shallow Dose Equivalent
*Well below the thresholds for any observable health effects
* Yield an occupational risk that is comparable to other light
- An individual receives approximately 300 mrem per year from
natural background radiation which includes natural sources, such
as cosmic rays, and naturally occurring radioactive
- Control dosimeters are used to subtract the signal from
natural background radiation, so that it is not included as part
of your occupational dose.
- Average Occupational dose for workers in the nuclear industry
is 450 mrem per year.