ML20147D724

Reg Guide 8.13,Rev 2, Instruction Concerning Prenatal Radiation Exposure

ML20147D724
Person / Time
Issue date:	12/31/1987
From:	NRC OFFICE OF NUCLEAR REGULATORY RESEARCH (RES)
To:
References
TASK-OP-031-4, TASK-OP-31-4, TASK-RE REGGD-08.013, REGGD-8.013, NUDOCS 8801200276
Download: ML20147D724 (10)

Text

_ _ _ _ _ _ _ _ _ _ _.

Revision 2

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U.S. NUCLEAR REGULATORY COMMISSION December 1987 Ps (g,+ g* OFFICE OF NUCLEAR REGULAT REGULATORY GUIDE 8,13 (Task OP 0314) i INSTRUCTION CONCERNING PRENATAL RADIATION EXPOSURE A.

INTRODUCTION basis for this guide.

The information couection requireme nts in 10 CFR Parts 19 and 20 have been Section 19.12, "Instructions to Workers," of 10 CFR cleared under OMB Clearance Nos. 3150-0044 and Part 19, "Notices, Instructions, and Reports to Worken; 3150-0014, respectively, inspections," requires that all individuals working in o -

frequenting any portion of a restncted areat be instructec B.

DISCUSSION in the health protection problems associated with expo-sure to radioactive materials or radiation, in precautions it has been known since 1906 that ceus that are divid-or procedures to rninimize exposure, and in the regula.

ing very rapidly and are undifferentiated in their structure tions that they are expected to obsene. The present and function are generauy more sensitise to radiation. In 10 CFR Part 20, "Standards for Protection Against the embryo stage, ceus meet both these criteria and Radiation," has no special hmit for exposure of the thus would be expected to be nighly sensitive to radia-embryo / fetus.2 Tlus guide describes the instructions an tion. Furthermore, there is direct evidence that the employer should provide to w orke rs and supen isors embryo / fetus is radiose nsitn e.

There is also evidence concerning biological nsks to the embryo / fetus exposed that it is especiauy sensitive to certain radiation effects to radiation, a dose hmit for the embryo / fetus that is dunns certain penods after conception, particularly under consideration, and sugsestions for reductng radia-dunng the first 2 to 3 months after conception when a tion exposure.

woman may not be aware that she is pregnant.

This regulatory guide takes into considera tion a Section 20.104 of 10 CFR Part 20 places different proposed revision to 10 CFR Part 20, which incorporates radiation dose limits on workers who are minors than the radiation protection guidance for the embryo / fetus on adult w orkers. Workers under the age of 18 are approved by the President in January 1987 (Ref.1).

limited to one tenth of the adult radiation dose hmits.

This revision to Part 20 was issued in January 1986 for floweser, the present NRC regulations do not estabhsh comment as a proposed rule. Comments on the guide as dose hmits specificauy for the embryo / fetus.

it pertains to the proposed Part 20 are encouraged. If the new Part 20 is codified, this regulatory guide wiu The NRC's present hmit on the radiation dose that be resised to conform to the new regulation and will can be received on the job is 1,250 milhrems per incorporate apprornate pubbe comments.

quarter (3 months).3 Working minors (those under 18) are limited to a dose equal to one-tenth that of adults, Any information couection actnities mentioned in 125 milhrems per quarter. (See @ 20.101 of 10 CFR this regulatory guide are contatned as requirements in Part 20.)

10 CFR Parts 19 or 20, which provide the regulatory Baause of the sensitisity of the unborn child, the National Council on Radiation Protection and Measure-i Restrkted area means any area that has controlled access to protect indMduals from besng exposed to radiation and radsoacthe ments (NCRP) has recommended that the dose equnalent materials.

I ln cortformity with the proposed resuaan to 10 C F R Part 20,

. The limit is 3,o00 millarerns per quarter if the w orker's occura.

l the term "ernbr)o/f:tus" is used throughout this docurnent to tional dose hsstory is known and the average dose does not enceed l represent all stages of pregnanc),

s,ooO millsrems per year.

USNRC REGU' ATORY GUIDES The guedes are issueo 6n the following ten broaa divisions:

Re9ulatory Gulces are 6ssued to oescribe and make available to the pu blic met hocs acceptable to tne NRC staff of emplementing

1. Power Reactors

6. Proowcts spectr6c parts of tne Commission's reawiations, to colineate tech-

2. Research and Test Reactors

7. Transportation neowes usec by the staff in evaswating specific problems or postw-

a. F uein and Materiais F acilities

8. Occupational Health tatea accioents, or to provice swicance to applicants. Hogwiatory

4. E nvironmental ano siting

9. Antitrust anc F inancial Review Gu6aes are not substitutes f or regwiations, and compitance with

s. Materials and plant protection lo. General them is not recutred. Methods ano solutions different from those set out in the guices nial te accootable if they provice a basis for the fmoings reautsite to the issuance or continwance of a perm 6t or Copies of usuea suues may be pure iased f r om the Government 16 conte by the Commission.

Printing Of fice at the current GPO price. I n f or ma t 6on on current GPo proces mov De obtainoa tsy contacting the Superintencent of This ow>as was tassed af ter consicerat6cn of comments received from Oc< u m e n t s, U. S.

Government Pr in t ing o f fice. Post of f ec e Bon the public, comments and swevestions f or emprovements in these 310 8 2. Washingt on, Dr 7001170a2, telechone (202)2 75 2060 or ewides are encouraged at sii times, and guides will t.e rev isec. as (202)275-2171, anpropriate, to accomrr wate comments and to reflect new inf orma-tion or sapertence.

IssueJ guces may also be purchased f r om the National Tec hnical Written comments may t's swbmittoa to the Rules ana Procedures i n t c,r ma t io n Service on a stanmng croer c a sis. Detasis on t his Branch, D R R,

ADM, U.S.

N u c lea r R eNie t or y C c m m ess4 on, servge may be obta6ned Dy eriting NTl5, s28s Port Royal R oad, Wash 6ngton DC 20ss5.

'-"eld, V A 2 2161.

8801200276 071231 PDR REGGD 08.013R PDR

to the unborn child from occupational exposure of the tions about the nsks of radiation exposure to the ex pectant mother be limited to 500 millirems for the embryo / fetus, entire pregnancy (Ref. 2). The 1987 Presidential guidance (Ref.1) specifies an cffective dose equivalent limit of The instructions should be presented both orally and 500 millirems to the unborn child if the pregnancy has in printed form, and the instructions shou'd include, as a minimum, the information provided in Appendix A been declared by the mother; the guidance also recom-mends that substantial variations in the rate of exposure (Instructor's Guide) to this guide. Individuals shouid be be avoided. The NRC (in Q 20.208 of its proposed revi-given the opportunity to ask questions and in turn sion to Part 20) has proposed adoption of the above should be questioned i determine whether they under-limits on dose and rate of exposure.

stand the instructions. M acceptable method of ensuring that the information is understood is to give a simple In 1971, the NCRP commented on the occupational written test covering the material included in Appen-exposure of fertile women (Ref. 2) and suggested that dix B (Pregnant Worker's Guide). This approach should fertile women should be employed only where the annual highlight for instructors those parts of the instructions dose would be unhkely to exceed 2 or 3 rems and would be that cause difficulties and thereby lead to appropriate accumulated at a more or less steady rate. In 1977, the modifications in the instructional curriculum.

ICRP recommended that, when pregnarcy has been diag-nosed, the woman work only where it is unlikely that the D. IMPLEMENTATION annual dose would exceed 0.30 of the dose-equivalent limit of 5 rems (Ref. 3). In other words, the ICRP has recom-The purpose of this section is to provide information mended that pregnant women not work where the annual to applicants and licensees regarding the NRC staff's dose might exceed 1.5 rem.

plans for unng this regulatory guide.

C. REGULATORY POSITION Except in those cases in which an applicant or licensee proposes an acceptable alternative method for instructions on radiation nsks should be provided complying with specified portions of the Commission's t

workers, including supervisors, in accordance with regulations, the NRC will use the material desenbed F

.2 of 10 CFR Part 19 before they are allowed to in this guide to evaluate the instructional program work in a restricted area. In providing instructions on presented to individuals, including supervisors, working radiation ruks, employers should include specific instruc-in or frequenting any portion of a restricted area.

l 1

8.13 2

APPENDIX A INSTRUCTOR'S GUIDE EFFECTS ON THE EMBRYO / FETUS OF EXPOSURE TO RADIATION AND OTHER ENVIRONMENTAL HAZARDS In order to decide whether to continue working excess cases of small head size was 5 per thousand; at 8 while exposed to ionizing radiation during her preg-to 1I weeks, it was 9 per thousand (Ref. 7).

nancy, a womsn should understand the potential effects on an embryo / fetus, including those that may be pro-In another study, the highest risk of mental retarda-

- " +

duced by various environmental risks such as smoking tion occurred during the S to 15 week period after and drinking. This will allow her to compare these risks conception (Ref. 8). A recent EPA study (Ref.16) has with those produced by exposure to ionizing radiation.

calculated that excess cases of mental retardation per live birth lie between 0.5 and 4 per thousand per rad.

'"g'hp '

-.is, Table 1 provides information on the potential effects resulting from exposure of an embry6etus to radiation 1.3 Genetic Effects 1W :py i'

and nonradiation risks. The secon, column gives the yg

..s p.d h rate at which the effect is produ ed by ratural causes Radiation induced genetic effects have not been observed

$ ?) Q $,t '

r in terms of the number per thot,and cases. The fourth to date in humans. The largest source of material for

1. 1. l.l. M i l column gives the number of additional effects per genetic studies involves the sursivors of Iliroshima and W

u-a thousand cases believed to be produced by expomre to Nagasaki, but tl 77,000 births that occurred among N%;)H the specified amount of the risk factor.

the survivors showed no evidence of genetic effects. For

(

doses received by the pregnant worker in the course of g

j The following section discusses the studies from employment considered in this guide, the dose received i

w hich the information in Table I was derived. The by the embryo / fetus apparently would have a negligible

.g _.. p.j results of exposure of the embryo / fetus to the risk effect on descendants (Refs.17 and 18).

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factors and the depenJence on the amount c.f the

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1.g 5. A s -l exposure are explained.

2. NONR ADI ATION RISKS

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1. RADIATION RISKE 2.1 Occupation N' 'i # ' h

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,3 1.1 Childhood Cancer A recent study (Ref. 9) involving the birth records of y

130,000 children in the State of Washmston indicates Numerous studies of radiation-induced childhood cancer that the risk of death to the unbore child is related to M.

j%.gik %e.N, have been performed, but a number of them are con-the occupation of the mother. Workers in the metal troversial. The National Academy of Science (NAS) BEIR industry, the chemical industry, medical technology, the T

. c.W b

'u.... J13 report reevaluated the date frnm these studies and even wood industry, the textile industry, and farms exhibited

'L i ' *...' j " !.61 reanalyzed the results. Some of the stronge" support for stillbirths or spontaneous abortions at a rate of 90 per

,;/. I h-.

a causal relationship is provided by twin data from the thousand above that of workers in the control group, Dy g,.h Oxford survey (Ref. 4). For maternal radiation doses of which consisted of workers in several other industries.

1,000 miUirems, the excess mtmber of deaths (above ihose M

'hh occurring from zatural causes) was found to be 0.6 2.2 Alcohol Mk g

death per thousand children (Ref. 4).

Je# 0 F4 It has been recognized since ancient times that alco-1.2 Mental Retardation and Abnormal Smallness of the hol consumption had an effect on the unborn child. Car-Head (Microcephaly) thaginian law forbade the consumption of wine on the wedding night so that a defective child might not be Studies of Japanese children who were exposed while in conceived. Recent studies have indicated that small the womb to the atomic bomb radiation at lliroshima and amounts of alcohol consumption have only the minor Nagasaki have shown evidence of both small head size and effect of reducing the birth weight slightly, but when mental retardation. Most of the children were exposed to consumption increases to 2 to 4 drinks per day, a pat-radiation doses in the range of 1 to 50 rads. The impor-tern of abnormalities called the fetal alcohol syndrome tance of the most recent study lies in the fact that (FAS) begins to appear (Ref. I1). This syndrome consists investigators were able to show that the gestational a?

of reduced growth in the unborn child, faulty brain func.

(age of the embryo / fetus after conception) at the time the tion, and abnormal facial features. There is a syndrome chi.tren were exposed was a critical factor (Ref. 7). The that has the same symptoms as full-blown FAS that app. iximate ruk of smaB head size as a function of occurs in children born to mothers who have not gestacional age is shown in Table 1. For a radiation dose consumed alcohol This nat urally occurnns syndrome of 1,000 millitems at 4 to 7 weeks after conception, the occurs in about I to 2 cases per thousand (Ref.10).

8.13 3

TABLE 1 EFFECTS OF RISK FACTORS ON PREGNANCY OUTCOME Number Occuning Excess occurrences Effect from Natural Causes Risk Factor from Risk Factor R ADIATION RISKS Childhood Cancer Cancer death in children 1.4 per thousand Radiation dose of 1000 millirems 0.6 per thousand (Ref. 5 )

received before birth (Ref. 4)

Abnormalities Radiation dose of 1000 millitads received during specific periods after conception' Small head size 40 per thousand 4 7 weeks after conception 5 per thousand (Ref. 6)

(Ref. 7)

Small head size 40 per thousand 811 w eeks after conception 9 per thousand (Ref. 6)

(Ref. 7)

Mental retardation 4 per thousand Radiation dose of 1000 millirad:

4 per thousand (Ref. 8) received 8 to 15 weeks after (Ref. 8) conception NONRADIATION RISKS Occupation Stillbirth or spontaneous 200 per thousand Work in high risk occupations 90 per thousand abortion (R ef. 9)

(see text)

( R ef. 9)

Alcohol Consumption (see text)

Fetal alcohol syndrome 1 to 2 per thousand 2-4 drinks per day 100 per thousand (Ref.10)

(Ref. I1)

Fetal alcohol syndrome I to 2 per thousand More thi.n 4 drtnks per day 200 per thousand (Ref.10)

(Ref.11)

Fetal alcohol syndrome I to 2 per thousand Chronic alcohobe (more than 350 per thousand (Ref.10) 10 drinks per day)

(Ref.12)

Perinatalinfant death 23 per thousand Chronic alcohobe (more than 170 per thousand (around the time of birth)

(Refs.13,14) 10 drinks per day)

(Ref.15)

Smoking Perinatal infant death 23 per thousand Less than i pack per day 5 per thousand

( R ef s.13.14)

(Ref.13)

Perinatal infant death 23 per thousand One pack or more per day 10 per thousand

( R e f s.13,14)

(Ref.13) 8.13-4

For mothers who consume 2 to 4 drinks per day, thousand for mothers who smoke one or more packs he excess occurroces number about 100 per thousand; per day (Ref.13).

nd for those who consume more than 4 drinks per

.a y, excess occurrences number 200 per thousand.

2.4 Miscellaneous

'he most sensitive period for this effect of alcohol preats to be the first few weeks after conception, Numerous other risks affect the embryo / fetus, only a

< fore the mother-to-be realizes she is pregnant (Refs.10 few of which are touched upon here. Most people are nd 11). Also,17% or 170 per thousand of the embryo /

familiar with the drug thalidomide (a sedative given to tuses of chronic alcoholics develop FAS and die before some pregnant women), which causes children to be (irth (Ref.15). FAS was first identified in 1973 in the born with missing limbs, and the more recent use of the hited States where less than full-blown effects of the drug diethylstilbestrol (DES), a synthetic estrogen given yndrome are now referred to as fetal alcohol effects to some women to treat menstrual disorders, which FAE) (Ref.12).

produced vaginal cancers in the daughters born to women who took the drug. Living at high altitudes also 4.3 Smoking gives rise to an increase in the number of low-birth-weight children born, while an increase in Down's Syndrome Smoking during pregnancy causes reduced birth (mongolism) occurs in children born to mothers who are reights in babies amour. ting to 5 to 9 ounces on the over 35 years of age. The rapid growth in the u e of

\\verage. In addition, there is an increased risk of 5 ultrasound in recent years has sparked an ongoing nfant deaths per thousand for mothers who smoke investigation into the risks of using ultrasound for ess than one pack per day and 10 infant deaths per diagnostic procedures (Ref.19).

i 5.13 5

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3 APPENDlX B PREGN ANT WORKE R'S GUIDE 8.9 [.t ; !. '

p., :s. j f f[ J, 7l.,,,k.C d-POSSIBLE HEALTH RISKS TO CHILDREN OF WOMEN WHO ARE EXPOSED TO RADIATION DURING PREGNANCY 2

.<7-During pregnancy, you should be aware of things in X Ray Procedure Average Dose'

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your surroundings or in your style of hfe that could 3 ' V p r Jlu."

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affect your unborn child. For those of you who work Normal chest examination 10 millirem in or visit areas designated as Restricted Areas (where Normal dental examination 10 miliem k _'

" = s.

access is controlled to protect individuals from being Rib cage examination 140 milhrem

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exposed to radiation and radioactive materials), it is Gall bladder examination 170 milbrem desirable that you understand the biological risks of Barium enema examination 500 milhrem g.ef ;

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radiation to your unborn child.

Pelvic examination 600 millirem N.

PNV O $

Everyone is exposed daily to various kinds of radia-

. variations by a tactor or 2 (above and below) are not unusuat.

tion: heat, light, ultraviolet, microw ave, ionizing, and so

@Q.f,

on. For the purposes of this guide, only ionizing radia-

.y.gf tion (such as x-rays, gamma rays, neutrons, and other

,.Q W.4) high-speed atomic particles) is considered. Actually, NRC POSITION j;7g. V

,2 everything is radioactive and all human activities involve

-.h h exposure to radiation. People are exposed to different NRC regulations and guidance are based on the -%

.. ' ei yy amounts of natural "background" ionizing radiation conservative asst mption that any ameunt of radiation, - a A

f.; h,if[ %y((

W depending on where they lise. Radon gas in homes is a no matter how small, can have a harmful effect on a i a.

f problem of growing concern. Br.ckground radiation comes adult, child, or unborn child. This assumption is said to from three sources:

be contenative because there are no iata showing ill e[T 1.((3 - '

Average effects from small do ses; the National Academy of yt

.~s a

A nnual Dose Sciences recently expressed "uncertainty as to whether a s/ [li..

Terrestrial radiation from soil dose of, say, I rad would have any effect at all."

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and rocks 50 millirem Although it is known ' hat the unborn child is more M

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Cosmic radiation from outer sensitive to radiatici, nan adults, particularly during

1. ;1 4o nM space 50 mtuirem certain stages of deselopment, the NRC has not estab -=~ '-

Radioactivity normally found hshed a special dose hmit for protection of the unborn within the human body 25 millirem child. Such a limit could result in job discrimination for women of child-bearing age and perhaps in the invasion 125 milhrem*

of privacy (if pregnancy tests were required) if a sepa-Dosage range (geographic and rate regulatory dose limit were specified for the unborn other factors) 75 to 5,000 millirem child. Therefore, the NRC has taken the position that special protection of the unborn child should be volun-The first two of these sources expose the body from tary and should be based on decisions made by workers the outside, and the last one exposes it from the inside.

and emplo)ers who are well mformed about the risks The average person is thus exposed to a total dose of invoh ed.

about 125 millirems per year from natural background radiation.

For the NRC position to tie effestive, it is important that both the employee and the employer understand in addition to ex posure from normal background the risk to the unborn child from radiation received as radiatio n, medical proced ure s may contribut e to the a result of the occupational exposure of the mother, dose people receise. The fouowing table lists the average This document tries to e x p!ain the risk as clearly as doses received by the bone marrow (the blood formms possible and to com pare it with other risks to the cells) from different medical applications, unborn child during pregnancy. It is hoped this will

• Ra.11ation doses in this document are desc.ribed in two cfferent help pregnant emplo)ees balance the risk to the unborn unita. De rsJ ta a mesaure of the amount of energy ahorbed in a child against the benefits of employment to decide if certain arnount of matettal (loo ergs per gram). Equal amounts of energy absorbed from J:rferelt types of radiation may lead to the risk is worth takmg. This docun'ent also discusses dirrerent teologkal effecto he rem is a urdt that redects the methods of keeping the dose, and therefore the risk, to b6olosteal damage done to the body. The mRhrad and milhrem refer to 1/1000 of a rad and a rem, respectively, the unborn child as low as is reasonably achievable.

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RADIATION DOSE LIMITS dures to limit the dose to the 500-millirem recommended Q Q Qh.

limit.

f r > 9.g[.;7g -

The NRC's present limit on the radiation dose that can n

JN n be received on the job is 1,250 millirems per quarter (3 It is important that the employee inform the hsY.eA months).* Working minors (those under 18) are limited to a employer of her condition as soon as she realizes she is dose equal to one-tenth that of adults,125 millirems per pregnant if the dose to the unborn child is to be

[ [ ['.. ]

quarter. (See { 20.101 of 10 CFR Part 2C.)

minimized.

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Because of the sensitivity of the unborn child,the National INTERNAL HAZARDS j '.h ' y 5

Council on Radiation Protection and Measurements (NCRP)

$.!,.Y[Wg'.,.

dj has recommended that the dose equivalent to the unborn This document has been directed primarily toward a

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child from occupational exposure of the expectant mother discussion c,f radiation doses received from sources outside e

be hmited to 500 millirems for the entire pregnancy (Ref. 2).

the body. Workers should also be aware that there is a

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gk 9 4 s.

_'t Thp 1987 Presidential guidance (Ref.1) specifies ar ef fective risk of radioactive material entering the body in work-dose equivalent limit of 500 millirems to the unborn child if places where unsealed radioactive material is used. Nuclear

,ms --- -

the pregnancy has been declared by the mother;the guidance medicine clinics, laboratories, and certain manufacturers g p g ghk.'

also recommends that substantial variations in the rate of use radioactive material in bulk form, of ten as a liquid or a exposure be avoided. The NRC(in } 20.208 ofits proposed gas. A list of the commonly used materiale and safety 7

revision to Part 20) has proposed adoption of the above precautions for each is beyond the scope of this document, limits on dose and rate of exposure.

but certain general precautions might include the follop" ADVICE FOR EMPLOYEE AND EMPLOYER

1. Do not smoke, eat, drink, or apply cosmeties around radioactive material.

Although the risks to the unborn child are small under normal working conditions, it is still advisable to limit the

2. Do not pipette solutions by mouth.

radiation dose from occupational exposure to no more than 500 millirems for the total pregnancy. Employee and

3. Use disposable gloves while handling radioactive employer should work together to decide the best method material when feasible.

for accomplishing this goal. Some methods that might be used include reducing the time spent in radiation areas, 4 Wash hands after working around radioactive wetring some shielding over the abdominal area, and keeping material.

an extra distance from radiation sources when possible. The employer or health physicist will be able to estimate the

5. Wear lab coats or other protectise clothing when-probable dose to the unborn child during the normal nine-eier there is a possibility of spills.

month pregnancy period and to inform the employee of the amount. If the predicted dose exceeds 500 milhrems, the Remember that the employer is required to have employec and employer should work out schedules or proce-demonstrated that it w tll have safe procedures and practices before the NRC issues it a iieense to use radioactive material. Workers are urged to follow estab-hshed procedures and consult the employer's radiation

,The Ifmit is 3,000 mmarems per quarter if the worker's occupa-safety officer or health physicist wheneser problems or tional dose Idstory is know11 and the average dose does not exceed questions arise.

s,ooo mav ems per year.

t 8.13 7

REFERENCES 1.

"Federal Radiation Protection Guidance for Occupa-

11. D. W. Smith, "Alcohol Effects on the Fetus," frorrtss tional Exposure," FedtralRtrister, p. 2822, January 27, in Clinical and Biological Research, Vol 36, pp. 73-82, 1987.

1980.

2.

National Council on Radiation Protection and hicasure-ments, "Basic Rrdiation Protection Criteria," NCRP

12. L. B. Robe, "Alcohol and Pregnancy," The American Report No. 39,1971.

hiedical Association, Box 10946, Chict o,1984.

3.

International Commission on Radiological Protection,

[

"Recommendations of the International Commission

13. hl. B. hieyer and J. A. Tonascia, "hf aternal Smoking, y?*

U on Radiological Protection," ICRP Publication No. 26, Pregnancy Complications, and Perinatal hfortality,"

Vol.1, No. 3,19 77.

American Journal of Obstetrics and Gynecology, Vol iMS 128, No. 5, pp. 494-502,1977.

4.

National Academy of Sciences,"The Effects on Popula-tions of Exposure to Low Levels of Ionizing Radiation

14. R. II. Mole, "Radiation Effects on Pre Natal Devel-(BEIR 111)," National Academy Press, Washington, DC, opment and Their Radiological Significance," De 1980.

British Journal of Radiology, Vol. 52, No. 614, pp.

89101, February 1979.

5.

J. L Young and R. W. Miller, "incidence of Malig-nant Tumors in U.S. Children," Journal of redia-

15. D. A. Roe, Alcohol and the Ditt, AVI Publishing trics, pp. 254-258,1975.

Company Inc., Westport, Connecticut,1979.

6.

W. J. Blot, "Growth and Des elopment Following

16. Environmental Protection Agency, "Radionuclides,"

j Prenatal and Childhood Exposure to Atomic Radia.

Background Information Document EPA 520/

1 tion," Journal of Radiation Research (Suppkment),

1-84-0221, pp. 8 56 8-63.

a pp. 8 2-85,1975.

M

-m 7.

R. W. Miller and J. J. Mulvihill, "Small llead Size Af ter

17. G. W. Beebe, "The Atomic Bomb Survivors and the

- 'E Atomic Radiation," Teratology, Vol 14, pp. 355 Problem of Low-Dose Radiation Effects," American 358, 1976.

/ournal of Epidemiology, Vol 114, No. 6, pp.

761 783, 1981.

8.

M. Otake and W. J. Schull, "In Utero Exposure to A bunb Radiation and Mental Retardation;a Reassess-m e nt," ne British fournal of Radiology, Vol. 57,

18. W. J. Blot et at, "Reproductive Potential of Males pp. 409-414,1954.

Exposed in Utero or Prepubertally to Atomic Radia-tion," in Atomic Bomb Casualty Commission Tech-9.

T. L Vaughan et al., "Fetal Death and Maternal nical Report TR 39 72, Radiation Effects Research Occupation," Journal of Occupatior,1 NcJicine, Foundation, Iliroshinia, Japan,1972.

Vol 26, No. 9, pp. 6 76 678,1984.

10. J. W. Ilanson, A. P. Streissguth, and D. W. Smith,

19. National Council on Radiation Protection and Measure-

"The Effects of Moderate Alc ohol Consumption ments, "Protection in Nuclear Medicine and Ultra-Dunng Pregnancy on Fetal Grow th and Morphogenesis,"

sound Diagnostic Procedures in Children," NCRP

/ournal of rediatrics, Vol 92, pp. 457 460,1978.

Report No. 73, 1983.

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VALUE/ IMPACT STATEMENT A draft value/ impact stat ement was published with final guide has not been prepared. A copy of the draft the proposed Revision to Regulatory Guide 8.13 S alue/ impact statement is available for inspection and (Task OP 0314) when the draft guide was published for copying for a fee at the Commission's Public Document public comment in August 1981. No changes were Room at 1717 11 Street NW., Washington, DC, under necessary, so a separate salue/ impact statement for the Task OP 0314.

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