DOE M 231.1-1A Chg 2, Environment, Safety and Health Reporting Manual
Functional areas: Defense Nuclear Facility Safety and Health Requirement, Environment, Safety, and Health, Requires Crosswalk When Revised, Safety
This Manual supplements DOE O 231.1A and provides detailed requirement for implementing Department of Energy reporting requirements, including time schedules for reporting and data elements to be reported. The page change modifies policy previously established that requires recording and reporting occupational injuries and illnesses of subcontractors employees. Change 1 dated 9-9-04. Change 2 dated 6-12-07. Canceled by DOE O 231.1B
Document text
Text extracted from the attached file. Refer to the original document for the authoritative version.
Section 1
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AVAILABLE ONLINE AT: INITIATED BY:
www.directives.doe.gov Office of Health, Safety and Security
MANUAL
Approved: 3-19-04
Chg 1: 9-9-04
Chg 2: 6-12-07
ENVIRONMENT, SAFETY AND HEALTH
REPORTING MANUAL
U.S. DEPARTMENT OF ENERGY
Chief Health, Safety and Security Officer
DOE M 231.1-1A
DOE M 231.1-1A Chg 2 i
6-12-07
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ENVIRONMENT, SAFETY AND HEALTH REPORTING MANUAL
1. PURPOSE. This Manual provides detailed requirements to supplement DOE O 231.1A,
Environment, Safety and Health Reporting, dated 8-19-03.
2. SUMMARY. This Manual is composed of three chapters and several appendices that
provide detailed requirements for implementing Department of Energy reporting
requirements, including time schedules for reporting and data elements to be reported.
3. CANCELLATIONS. The directives listed below are cancelled. Cancellation of a
directive does not, by itself, modify or otherwise affect any contractual obligation to
comply with such a directive. Cancelled directives that are incorporated by reference in a
contract remain in effect until the contract is modified to delete the reference to the
requirements in the cancelled directives.
a. DOE M 231.1-1, Environment, Safety and Health Reporting Manual, dated
9-30-95.
b. DOE N 231.1, Environment, Safety, and Health Reporting Notice, dated 1-15-02.
4. APPLICABILITY.
a. All Departmental Elements. Except for the exclusions in paragraph 4c, this
directive applies to all DOE elements. This directive automatically applies to
DOE elements created after it is issued.
The Administrator of the National Nuclear Security Administration (NNSA) will
assure that NNSA employees and contractors comply with their respective
responsibilities under this Manual.
b. DOE Contractors.
(1) Except for the exclusions in paragraph 4c, the Contractor Requirements
Document (CRD), Attachment 1, sets forth requirements of this Manual
that will apply to contracts that include the CRD.
(2) The CRD must be included in contracts that involve activities covered by
the recordkeeping and reporting requirements in the CRD for contractor
employee injury or illness and radiation exposure. The CRD must also be
included in contracts that involve activities covered by the environmental
protection program reporting requirements and the annual fire protection
summary requirements in the CRD.
(3) The officials identified in the Responsibilities paragraphs are responsible
for telling contracting officers which contracts are affected by this
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Manual. Once notified, contracting officers are responsible for
incorporating the CRD into each affected contract.
c. Exclusions.
(1) Activities conducted under the authority of the Deputy Administrator for
Naval Reactors, pursuant to Executive Order 12344, as set forth in Public
Law 98-525 and Public Law 106-65, with the exception of reporting
required by 29 CFR 1960.
(2) Activities conducted by Bonneville Power Administration as authorized
by Delegation Order No. 00–033.00A.
5. RESPONSIBILITIES.
a. Primary DOE Organizations. Specific reporting responsibilities are provided in
each chapter of this Manual by subject area.
b. Heads of DOE Elements.1 Designate responsible individuals to notify the
appropriate contracting officer(s) of affected contracts and verify that the CRD is
incorporated into relevant contracts. Provide program direction to implement the
reporting requirements in accordance with this Manual.
Section 2
c. Chief Health, Safety and Security Officer.
(1) Maintains responsibilities for sustaining an effective Occupational Injury
and Illness Recordkeeping and Reporting Program, including the
Computerized Accident/Incident Reporting System which is the
supporting computer data system.
(2) Maintains and develops the supporting computer data system, the
Computerized Accident/Incident Reporting System.
(3) Conducts periodic independent sample quality assurance reviews of DOE
and DOE contractors for occupational injury and illness reporting.
(4) Maintains and develops the Web-based Pollution Prevention Performance
Tracking and Reporting System and provides supporting data-entry
instruction, and environmental performance reporting guidance.
1Whenever the term Heads of Headquarters Elements is used in this Manual, it includes Secretarial Officers,
Administrator for NNSA, Administrators for the Power Administrations, and Heads of Staff Offices. Likewise,
whenever the term Heads of Field Elements is used in this Manual, it includes Operations Offices, Field Offices,
Site Offices, Service Centers, Project Offices, and Area Offices.
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6. ACRONYMS. See Appendix A for a list of acronyms used in this Manual.
7. CONTACT. Questions concerning this Manual should be referred to the Office of
Corporate Safety Analysis at 301-903-6096.
BY ORDER OF THE SECRETARY OF ENERGY:
KYLE E. McSLARROW
Deputy Secretary
DOE M 231.1-1A v
3-19-04
CONTENTS
CHAPTER I. REPORTING ENVIRONMENTAL PROTECTION INFORMATION
1. Environmental Protection Program Reporting ........................................................................ I-1
2. Annual Site Environmental Report ......................................................................................... I-1
3. National Environmental Policy Act (NEPA) Reporting ......................................................... I-2
CHAPTER II. REPORTING OCCUPATIONAL SAFETY AND HEALTH INFORMATION
1. Injury and Illness Recordkeeping and Reporting...................................................................II-1
a. Work-Related Fatalities, Injuries, and Illnesses ..............................................................II-1
b. Data Collection and Summarization ................................................................................II-2
c. Report Submission—DOE F 5484.3 ...............................................................................II-3
d. Submission of Work Hours—DOE F 5484.4 ..................................................................II-3
e. Posting OSHA Form 300A ..............................................................................................II-3
f. Supplemental Requirements Regarding Accident/Incident Reports ................................II-3
2. Annual Fire Protection Program Summary ............................................................................II-5
3. Reporting Information for Epidemiologic Analyses–Excess
Injuries and Illnesses ..............................................................................................................II-6
4. Reporting Information for Epidemiologic Analyses–OSH Studies .......................................II-6
5. Annual Report to the Secretary of Energy .............................................................................II-6
6. Annual Federal Employee Occupational Safety and Health (FEOSH) Report .....................II-7
Section 3
CHAPTER III. REPORTING IONIZING RADIATION EXPOSURE INFORMATION
1. Exposure Reports to the Radiation Exposure Monitoring
System (REMS) Repository ................................................................................................. III-1
a. Annual Individual Radiation Exposure Records ............................................................ III-1
b. Radiation Exposure Records for Special Individuals .................................................... III-1
c. Report Format ................................................................................................................ III-1
d. Exposure Reports to Individuals .................................................................................... III-1
ATTACHMENT 1. CONTRACTOR REQUIREMENTS DOCUMENT
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CONTENTS (continued)
APPENDIXES
APPENDIX A. ACRONYMS
APPENDIX B. OSHA FORMS 300 AND 300A
APPENDIX C. INDIVIDUAL ACCIDENT/INCIDENT REPORT—DOE F 5484.3
APPENDIX D. TABULATION OF WORK HOURS—DOE F 5484.4
APPENDIX E. ACCESSING CAIRS AND OBTAINING ORGANIZATION CODES
APPENDIX F. ANNUAL FIRE PROTECTION SUMMARY
APPENDIX G. INSTRUCTIONS FOR PREPARING OCCUPATIONAL EXPOSURE DATA
FOR SUBMITTAL TO THE RADIATION EXPOSURE MONITORING
SYSTEM (REMS) REPOSITORY
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CHAPTER I. REPORTING ENVIRONMENTAL PROTECTION INFORMATION
1. ENVIRONMENTAL PROTECTION PROGRAM REPORTING.
a. Heads of Headquarters Elements and Heads of Field Elements, for matters under
their purview, must:
(1) Ensure that the information needed to meet the requirements of DOE
O 450.1, Environmental Protection Program, is reported annually
considering annual guidance provided by the Chief Health, Safety and
Security Officer as follows:
(a) Information on site progress in implementing Environmental
Management Systems (EMSs).
(b) Information on site progress in reducing or eliminating the
generation of waste, the release of pollutants to the environment,
and the use of Class I ozone-depleting substances (ODS). Site
reporting must be accomplished utilizing the Web-based Pollution
Prevention Performance Tracking and Reporting System.
(c) Information on site procurement of recycled-content materials and
environmentally preferable products and services. Site reporting
must be accomplished utilizing the Web-based Pollution
Prevention Performance Tracking and Reporting System.
(d) Information on pollution prevention award nominations from sites,
and nominations selected as “best in class” by heads of Primary
DOE Organizations. The Chief Health, Safety and Security
Officer will submit the selected “best in class” pollution
prevention awards to the White House “Closing the Circle” award
competition. Site reporting must be accomplished utilizing the
Web-based Pollution Prevention Performance Tracking and
Reporting System.
2. ANNUAL SITE ENVIRONMENTAL REPORT.
a. Heads of Field Elements will prepare an integrated Annual Site Environmental
Report for each calendar year. This report must present summary environmental
data in order to:
(1) Characterize site environmental management performance. Include data
on effluent releases, environmental monitoring, and estimated radiological
doses to the public from releases of radioactive material at DOE sites.
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(2) Summarize environmental occurrences and responses reported during the
calendar year (CY).
Section 4
(3) Confirm compliance with environmental standards and requirements.
(4) Highlight significant programs and efforts. Include environmental
performance indicators and/or performance measures programs. The
breadth and detail of this reporting should reflect the size and extent of
programs at a particular site.
The Annual Site Environmental Report for the calendar year will be completed
and made available to the public by October 1 of the following year and will be
submitted to the Chief Health, Safety and Security Officer at that time.
b. The Office of Corporate Safety Analysis will continue to issue annual guidance to
all DOE Headquarters and field elements regarding the preparation of the Annual
Site Environmental Reports.
3. NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) REPORTING.
a. Heads of Headquarters and Field Elements with responsibility for NEPA matters,
will (subject to the exclusion of the Naval Nuclear Propulsion and the special
provisions for the National Nuclear Security Administration described in DOE
O 451.1B):
(1) Submit an annual report to the Office of NEPA Policy and Compliance on
progress in implementing, and the effectiveness of, any commitment for
environmental impact mitigation that is essential to render the impacts of a
proposed action not significant or that is made in a record of decision.
The report may be submitted on the mitigation action plan anniversary or
as part of a combined report (for example, as part of the annual NEPA
planning summary) for multiple plans until mitigation has been completed.
(2) Submit an annual NEPA planning summary to the General Counsel (GC-
1) by January 31 of each year and make it available to the public. The
current version of DOE O 451.1B, National Environmental Policy Act
Compliance Program, describes the contents of the annual NEPA
planning summary.
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CHAPTER II. REPORTING OCCUPATIONAL SAFETY AND
HEALTH INFORMATION
1. INJURY AND ILLNESS RECORDKEEPING AND REPORTING. It is DOE policy
that environmental, safety, and health reports be complete and readily available for
authorized dissemination outside the cleared community. When accidents or incidents
occur in Unclassified Controlled Nuclear Information (UCNI) sensitive facilities and/or
involve classified operations, the local classification officer will be consulted to verify
that such reports do not inadvertently disclose classified or unclassified controlled
information (such as UCNI or Official Use Only information.) If classification concerns
appear to inhibit completely forthright reporting, the Office of Classification will provide
assistance in creating complete yet unclassified reports. If this cannot be accomplished,
the reports will be annotated to indicate the existence, identification and file location of
any classified addendum.
a. Work-Related Fatalities, Injuries, and Illnesses. Heads of Headquarters Elements
and Heads of Field Elements will require DOE contractors to report work-related
fatalities, injuries, and illnesses occurring among DOE contractor/subcontractor
employees and arising out of work primarily performed at DOE-owned or DOE-
leased facilities under their direction. Reports will be submitted to the Chief
Health, Safety and Security Officer according to procedures provided in
paragraphs 3a through 3g of the CRD to this Manual. Periodic, at least twice per
year, quality checks will be performed to verify that the information recorded and
reported to DOE, through the Computerized Accident/Incident Reporting System,
regarding work related injuries and illnesses to DOE contractor employees is
thorough, accurate, and consistent with information contained in local records.
Section 5
Heads of Field Elements and the Director for the Office of Management (for
Headquarters, including NNSA Headquarters) will record occupational fatalities,
injuries, and illnesses occurring among Federal employees arising out of work
primarily performed at DOE-owned or DOE-leased facilities. Reports of work-
related fatalities, injuries, and illnesses to DOE employees will comply with the
recordkeeping and reporting requirements contained in the current version of Title
29, Code of Federal Regulations (CFR), Part 1960, Subpart I, with modifications
that follow in paragraphs 1a(1) through 1a(5) and 1c through 1f, below.
(1) Record all recordable occupational injuries and illnesses experienced by
DOE employees on the Log of Work-Related Injuries and Illnesses,
OSHA Form No. 300, and complete an annual summary of the
information contained on OSHA Form No. 300 using the Summary of
Work-Related Injuries and Illnesses, OSHA Form No. 300A (see
Appendix B).
(2) Record and report all DOE employee recordable work-related injuries and
illnesses on the electronic form DOE F 5484.3, Individual
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Accident/Incident Report, in lieu of OSHA Form No. 301, Injury and
Illness Incident Report.
Reports must be submitted to the Computerized Accident/Incident
Reporting System (CAIRS) by either method identified in paragraph 1c
below to satisfy this requirement. (See Appendix C for a list of data
elements included in the form.) Access to DOE F 5484.3 data will be in
accordance with paragraph 1f(3) of this chapter. Reports will be
submitted in accordance with paragraphs 1c below.
(3) Report total employee hours worked on the electronic form DOE
F 5484.4, Tabulation of Work-Hours. (See Appendix D for a list of data
elements included in the form.) Reports will be submitted in accordance
with paragraph 1d below. Access to the DOE F 5484.4 data will be in
accordance with paragraph 1f(3)of this chapter.
(4) Report work-related incidents that involve a fatality or hospitalization of
three or more DOE employees, in accordance with the requirements of
29 CFR 1960.70 to the Chief Health, Safety and Security Officer through
the designated Federal Employees Occupational Safety and Health
Program (FEOSH) Manager.
(5) Perform periodic, at least quarterly, quality checks of the information
recorded and reported to CAIRS on work related injuries and illnesses to
Federal employees to verify that the information is thorough, accurate, and
consistent with information contained in local records.
(6) Analyze reports of DOE occupational injuries and illnesses to identify
trends and preventive measures.
b. Data Collection and Summarization.
(1) Data Collection. The Chief Health, Safety and Security Officer is
responsible for maintaining a centralized operational database of reports
submitted in accordance with paragraphs 1c and 1d below. The current
system, the Computerized Accident/Incident Reporting System (CAIRS),
compiles case information from accident reports submitted by DOE,
contractor, and subcontractor employees. The database collects
information electronically using either file transfer features in CAIRS
Bulk Upload Processing (CBUP) or the direct data entry form features in
CAIRS Direct Data Entry (CDDE). A list of data elements to be included
in the CAIRS database is provided in Appendix C.
Section 6
(2) Periodic Summary of Accident Data. DOE-wide statistical summary
information taken from reports submitted in accordance with
paragraphs 1c and 1d below will be available through CAIRS quarterly
summary reports.
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c. Report Submission—DOE F 5484.3. Effective 180 days following the approval of
DOE M 231.1-1A, DOE F 5484.3 will be submitted electronically only, using
either CAIRS Bulk Upload Processing or by entering information into the
electronic form using CAIRS Direct Data Entry. New reports (DOE F 5484.3) will
be submitted at least twice per month for receipt on or before the 15th of the month
and the last working day of the month. Initial reports will include the actual work
time lost as of the date the report is submitted. Revisions to lost work time will be
submitted quarterly until the case is closed. Quarterly revisions for lost work time
and any other information that requires revising information initially reported will
be submitted for receipt by the 10th of the month following the end of the calendar
quarter, i.e., April 10th, July 10th, October 10th, and January 10th. Prior to the
transition to required electronic reporting only, legible copies of new and or revised
report forms may be mailed. Mailed report forms should be addressed to the
CAIRS Data Coordinator, U.S. Department of Energy, HS-30/Bldg. 270 CC,
1000 Independence Ave., S.W., Washington, DC 20585-0270. Additional
information about accessing CAIRS and electronic report submission is included in
Appendix E of DOE M 231.1-1A and on the Internet at the R&R References and
Resources Web page (http://www.hss.energy.gov/csa/csp/cairs/refs.html)
d. Submission of Work Hours, DOE F 5484.4. Effective 180 days following the
approval of DOE M 231.1-1A, DOE F 5484.4 will be submitted electronically
only by entering information into the electronic form using CAIRS Direct Data
Entry. Quarterly work-hours will be submitted by the 10th of the month
following the end of the quarter (e.g., first quarter CY reports are due April 10).
Prior to the transition to electronic reporting only, legible copies of completed
report forms (DOE F 5484.4) may be mailed. Mailed report forms should be
addressed to the CAIRS Data Coordinator, U.S. Department of Energy,
HS-30/Bldg. 270 CC, 1000 Independence Ave., S.W., Washington,
DC 20585-0270. Additional information about accessing CAIRS and electronic
report submission is included in Appendix E of DOE M 231.1-1A and on the
Internet at the R&R References and Resources Web page
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
e. Posting OSHA Form 300A. OSHA Form No. 300A, will be completed, certified,
and posted annually. (See requirements in 29 CFR 1960.66 and 1960.67.)
f. Supplemental Requirements Regarding Accident/Incident Reports. Heads of
Headquarters Elements and Heads of Field Elements will verify that DOE and
DOE contractors are in compliance with the following requirements.
(1) Retention of Injury/Illness Records and Reports. Heads of Headquarters
Elements and Heads of Field Elements will require DOE and DOE
contractors to retain personal injury and illness records pursuant to DOE
O 200.1, Information Management Program, dated 9-30-96. DOE
elements will require DOE site/facility management contractors, upon
termination of contracts for work being performed for DOE, to submit
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Section 7
injury and illness records to the site/facility management contractor
organization that will assume OSH responsibilities for the facility.
Additionally, Heads of Headquarters Elements and Heads of Field
Elements will require DOE site/facility management contractors assuming
OSH responsibilities for work being performed for DOE to retain previous
operating contractors’ accident records.
(2) Maintenance of Injury and Illness Reports. Heads of Headquarters
Elements and Heads of Field Elements will maintain injury and illness
records pursuant to 29 CFR 1960.66 and 1960.69. Heads of Headquarters
Elements and Heads of Field Elements will ensure that DOE site/facility
management contractors assuming OSH responsibilities for work being
performed for DOE will maintain previous operating contractors’ accident
records.
(3) Access to Accident Records and Reports.
(a) An employee, former employee, and/or his/her representatives
have the right to limited access of the OSHA Form No. 300 that
contains the employee’s name.
(b) Access is limited according to the requirements of the Privacy Act,
Section 5 U.S.C § 552a and the Freedom of Information Act
(FOIA). In accordance with requirements contained in Section 5
U.S.C.§ 552(b)(6) of the FOIA, access to information on any log
maintained for DOE or by DOE or DOE contractors, will be
restricted to information that does not constitute an unwarranted
invasion of personal privacy. An employee whose name does not
appear on a log will be limited to information that does not identify
any injured or ill employees, and will not be provided access to the
names of the injured or ill employees. An employee, former
employee, and/or authorized representatives will have access to
DOE F 5484.3 data that contains the employee’s name as the
injured or ill worker. Additional information on employee rights
of access to these forms is provided in 29 CFR subparts 1960.66
and 1960.69.
(c) Records listed in 29 CFR 1904.4 and 1904.5 (or the DOE
equivalent of these records) will be made available for inspection
and copying by any Department of Energy representative for the
purpose of conducting oversight assessments or for statistical
compilation.
(d) Records required to be maintained under the provisions of 29 CFR
subparts 1960.66 will be made available upon request to the
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Secretary of Labor and the Secretary of Health and Human
Services or their authorized representatives.
(4) Updating Accident Records and Reports. Heads of Headquarters
Elements and Heads of Field Elements will require DOE and DOE
site/facility management contractors to update OSHA Form No. 300
pursuant to 29 CFR 1960.66 and 1960.69 and 29 CFR 1904.33. Each
quarter, for at least one year from the date of the injury/illness, DOE
elements must update each DOE F 5484.3 that includes lost work time
(either days away from work or days restricted/transferred) for a DOE
employee and verify that contractors update this information for
contractor employees. DOE F 5484.3 should be updated to indicate
changes in lost work time or changes in the description or outcome of
the case.
(5) Interpretation of Reporting Requirements. For additional information
or interpretation of occupational injury and illness reporting
requirements contained in this Manual, contact the Office of Corporate
Safety Analysis.
Section 8
(6) Reporting Injury and Illness Cases to Subcontract Employees. Attachment 1,
paragraphs 3c, 3d, and 3e provide requirements for DOE contractors relating
to reporting occupational injury and illness cases that occurred to
subcontractor employees. Heads of Headquarters Elements or their
designated DOE field organization contacts can approve exemptions to DOE
contractors from the requirements in Attachment 1, paragraph 3d. They can
also approve an alternative method to the method required in Attachment 1,
paragraph 3e for reporting injuries and illness to select subcontractors who
meet either of the conditions in paragraph 3d.
2. ANNUAL FIRE PROTECTION SUMMARY. Organizations responsible for
maintaining property under stewardship of DOE and the Administrator, NNSA, will seek
concurrence with their appropriate Head of Field Element and submit specifically
formatted fire protection program CY summary reports to the Chief Health, Safety and
Security Officer by April 30 of the following year. The Chief Health, Safety and
Security Officer will provide reporting organizations and DOE Field Elements with a
computer-based application for submitting formatted summaries and will maintain a
database reporting system that compiles reports submitted in accordance with the
reporting elements described in Appendix F. The Chief Health, Safety and Security
Officer will produce a CY summary of Fire Protection Programs for the Department and
will make available a database summary of all reporting elements of DOE contractors
and DOE Field Elements for trending data supplemental to the Environment, Safety and
Health annual summary report.
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3. REPORTING INFORMATION FOR EPIDEMIOLOGIC ANALYSES—EXCESS
INJURIES AND ILLNESSES.
a. Heads of Headquarters Elements and Heads of Field Elements will notify the
Chief Health, Safety and Security Officer of suspected illness or injury excesses
that require epidemiologic investigation. In this context, suspected excess means
the perception that an unusually high number of cases may be occurring among a
group of workers. Epidemiologic analyses can help determine whether suspected
illness or injury excesses are greater than expected and are associated with
working conditions. Any worker, individual, or group (for example, safety and
health staff, supervisors, or employee representatives) can identify suspected
illness or injury excesses.
b. The Chief Health, Safety and Security Officer, who is responsible for all
Departmental health studies of human populations, directs the investigations of
suspected excesses through staff of the Office of Injury and Illness Prevention
Programs.
c. Reporting organizations participate in epidemiologic investigation(s), which will
determine the number of affected individuals, their medical diagnoses, and their
hazard exposures. The investigation may involve medical tests, work place
surveys, and reviews of personnel, medical, and exposure records.
4. REPORTING INFORMATION FOR EPIDEMIOLOGIC ANALYSES—OSH
STUDIES.
Section 9
a. The September 2000 memorandum of understanding between DOE and the
Department of Health and Human Services (DHHS), which supersedes the
December 1990 memorandum, reassigned management responsibility for a range
of epidemiologic research projects and related activities addressing worker and
community health to the DHHS Centers for Disease Control and Prevention
(CDC) constituent agencies, including the National Institute for Occupational
Safety and Health, the Agency for Toxic Substances and Disease Registry, and
the National Center for Environmental Health. Much of the research focuses on
illness, injury, and death to determine whether exposure to ionizing radiation and
chemicals has had impact on worker health. These agencies have become users of
data collected originally to fulfill OSHA requirements and collectors of additional
research data.
b. Heads of Field Elements will provide CDC officials, their contractors, and
grantees access to the DOE facilities, workers, information, and data needed to
conduct these studies. The investigators will comply with Privacy Act and
security requirements.
5. ANNUAL REPORT TO THE SECRETARY OF ENERGY. The Chief Health, Safety
and Security Officer shall submit an annual report to the Secretary describing the status
and adequacy of DOE, including NNSA, and contractor performance of their
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occupational safety and health responsibilities. The annual report for the calendar year
will be submitted to the Secretary by May of the following year.
6. ANNUAL FEDERAL EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH
REPORT. The Director for the Office of Corporate Safety Analysis is designated by the
Chief Health, Safety and Security Officer to prepare and submit an annual fiscal year
report to the Department of Labor on the DOE occupational safety and health program.
The report will contain such information as the Secretary of Labor prescribes. [See 29
CFR 1960.71.]
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CHAPTER III. REPORTING IONIZING RADIATION EXPOSURE INFORMATION
1. EXPOSURE REPORTS TO THE RADIATION EXPOSURE MONITORING SYSTEM
(REMS) REPOSITORY.
a. Annual Individual Radiation Exposure Records.
(1) Heads of Headquarters Elements and Heads of Field Elements will report
annual radiation exposure records required by 10 CFR 835.702(a) and (b)
to the REMS repository by March 31 for the preceding monitoring year.
The records should include exposure records for special individuals as
described in paragraph 1b(1) of this chapter.
(2) Revisions to radiation exposure records for monitoring periods beginning
on or after January 1, 1989, will be reported to the REMS repository.
Revised records for prior monitoring years will be submitted annually by
March 31. However, if the revised dose record results in a dose exceeding
regulatory dose limits defined in 10 CFR 835.202, revised records will be
submitted within 30 days of the date that the dose record is revised.
Revised records should be submitted to the REMS repository in a separate
file, but in the same format as annual records. The transmittal
documentation should note that the enclosed records are revised.
b. Radiation Exposure Records for Special Individuals.
Section 10
(1) A special individual is a person employed by DOE Headquarters, a
contractor supporting DOE Headquarters or Field Office activities, a Defense
Nuclear Facilities Safety Board employee or contractor, or an International
Atomic Energy Agency inspector who visits a DOE or DOE contractor site
or facility to conduct Department-related business. Radiation exposure data
pertaining to special individuals will be reported to the REMS repository
within 30 days after the determination of the dosimetry.
(2) Each DOE or DOE contractor employee or a special individual who visits,
in an official capacity, a radiological site outside of the DOE shall arrange
to have all pertinent occupational radiological exposure data to his or her
employer within 30 days after determination of the dosimetry.
(3) Heads of Headquarters Elements, Heads of Field Elements, and
contractors shall verify that such procedures exist and are effective in
support of paragraph 1b(2) above.
c. Report Format. All radiation exposure reports of records collected during and
after CY 2005 and sent to the REMS repository as noted in paragraphs 1a and 1b
must be submitted in electronic format and prepared in accordance with
Appendix G of this Manual.
d. Exposure Reports to Individuals. Reports to individuals must be prepared in
accordance with 10 CFR 835.801.
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CONTRACTOR REQUIREMENTS DOCUMENT
DOE M 231.1-1A, ENVIRONMENT, SAFETY, AND HEALTH REPORTING
Regardless of the performer of the work, contractors with the CRD incorporated into their
contracts are responsible for compliance with the requirements of the CRD. Affected contractors
also are responsible for flowing down the requirements of the CRD to subcontracts at any tier to
the extent necessary to ensure the contractor’s compliance with the requirements. In doing so,
the contractor must not unnecessarily or imprudently flow down requirements to subcontracts.
That is the contractor must both ensure that it and its subcontractors comply with the
requirements of this CRD and only incur costs that would be incurred by a prudent person in the
conduct of competitive business. The contractor must develop site-wide and facility-wide
procedures, protocols, or other methods to meet the reporting requirements in this CRD as
indicated below.
1. ENVIRONMENTAL PROTECTION PROGRAM REPORTING. Ensure that
environmental, safety, and health reports are complete and readily available for
authorized dissemination outside the cleared community. Ensure that when accidents or
incidents occur in Unclassified Controlled Nuclear Information (UCNI) sensitive
facilities and/or involve classified operations, the local classification officer is consulted
to ensure that such reports do not inadvertently disclose classified or unclassified
controlled information (such as UCNI or Official Use Only information.) If classification
concerns appear to inhibit completely forthright reporting, the Office of Classification
will provide assistance in creating complete yet unclassified reports. If this cannot be
accomplished, the reports must be annotated to indicate the existence, identification and
file location of any classified addendum.
Ensure the information described below is reported annually, considering annual
guidance provided by the Chief Health, Safety and Security Officer on the Web-based
Pollution Prevention Tracking and Reporting System (PPTRS), unless otherwise
indicated. (These reporting requirements relate to activities carried out or conducted
under the contractor’s ISMS and the CRD to DOE O 450.1, Environmental Protection
Program.)
Section 11
a. Information on site progress in implementing Environmental Management
Systems (EMSs) shall be reported to the Cognizant Secretarial Officer and the
Chief Health, Safety and Security Officer, as appropriate.
b. Information on site progress in reducing or eliminating the generation of waste,
the release of pollutants to the environment, and the use of Class I
ozone-depleting substances (ODS).
c. Information on site procurement of recycled-content materials and
environmentally preferable products and services.
Attachment 1 DOE M 231.1-1A Chg 2
Page 2 6-12-07
Vertical line denotes change.
d. Information on pollution prevention award nominations from sites, and
nominations selected as “best in class” by Heads of Headquarters Elements and
Heads of Field Elements.1 The Chief Health, Safety and Security Officer will
submit the selected “best in class” pollution prevention awards to the White
House “Closing the Circle” award competition.
2. ANNUAL SITE ENVIRONMENTAL REPORT. Provide all necessary assistance,
including partial or full preparation of the Annual Site Environmental Report (ASER), to
the Head of the Field Element, as directed and appropriate, in meeting the annual site
environmental reporting requirement to DOE headquarters each October 1st.
a. Ensure that information needed to prepare an integrated Annual Site
Environmental Report for each calendar year is provided to the Head of the Field
Element. This information will include summary environmental data in order to:
(1) Characterize site environmental management performance. Include data
on effluent releases, environmental monitoring, and estimated radiological
doses to the public from releases of radioactive material at DOE sites.
(2) Summarize environmental occurrences and responses reported during the
calendar year (CY).
(3) Confirm compliance with environmental standards and requirements.
(4) Highlight significant programs and efforts. Include environmental
performance indicators and/or performance measures programs. The
breadth and detail of this reporting should reflect the size and extent of
programs at a particular site.
The Annual Site Environmental Report for the calendar year will be completed
and made available to the public by October 1 of the following year, and an
informational copy will be submitted to the Chief Health, Safety and Security
Officer at that time.
b. Ensure adherence to the reporting schedule and guidance provided by the Office
of Corporate Safety Analysis regarding reporting information for the Annual Site
Environmental Reports.
3. INJURY AND ILLNESS RECORDKEEPING AND REPORTING. Ensure that
environmental, safety, and health reports are complete and readily available for
1Whenever “Heads of Headquarters Elements” is used in this CRD, it includes Secretarial Officers, Administrator
for NNSA, Administrators for the Power Administrations, and Heads of Staff Offices. Likewise, whenever Heads
of Field Elements is used in this CRD, it includes Operations Offices, Field Offices, Site Offices, Service Centers,
Project Offices, and Area Offices.
DOE M 231.1-1A Chg 2 Attachment 1
6-12-07 Page 3
Vertical line denotes change.
Section 12
authorized dissemination outside the cleared community. Ensure that when accidents or
incidents occur in Unclassified Controlled Nuclear Information (UCNI) sensitive
facilities and/or involve classified operations, the local classification officer is consulted
to ensure that such reports do not inadvertently disclose classified or unclassified
controlled information (such as UCNI or Official Use Only information.) If classification
concerns appear to inhibit completely forthright reporting, the Office of Classification
will provide assistance in creating complete yet unclassified reports. If this cannot be
accomplished, the reports must be annotated to indicate the existence, identification, and
file location of any classified addendum.
a. At a facility or site where DOE is exercising its authority to regulate worker
safety and health (rather than have the Occupational Safety and Health
Administration directly regulate the facility or site) the contractor is responsible
for keeping records for work-related fatalities, injuries, and illnesses. Unless
otherwise directed in this CRD, the contractor must ensure that records are kept as
directed in Title 29 Code of Federal Regulations (CFR) 1904.4 through 1904.11,
1904.29 through 1904.32, 1904.44, and 1904.46.
b. Ensure that the following recording and reporting requirements are followed.
(1) Record all recordable work-related contractor employee fatalities, injuries,
and illnesses on Occupational Safety and Health Administration (OSHA)
Form No. 300, Log of Work-Related Injuries and Illnesses, and complete
an annual summary of the information contained on OSHA Form No. 300
using OSHA Form No. 300A, Summary of Work-Related Injuries and
Illnesses [See Appendix B to DOE M 231.1-1A].
(2) Record and report all recordable work-related contractor employee
fatalities, injuries and illnesses on the form DOE F 5484.3, Individual
Accident/Incident Report, in lieu of the OSHA Form No. 301, Injury and
Illness Incident Report. Reports must be submitted to the Computerized
Accident/Incident Reporting System (CAIRS). Either method identified
in paragraph 3f below satisfies this requirement. (See Appendix C for a
list of data elements included in the form.) Access requirements for DOE
F 5484.3 data are described in paragraph 3i below. Submission and
posting of reports are described in 3f and 3h below.
(3) Report employees’ total hours worked on DOE F 5484.4, Tabulation of
Work-Hours. Access requirements for DOE F 5484.3 data are described
in paragraph 3i below. Submission of reports is described in 3g below.
(4) Conduct periodic, at least quarterly, quality checks of the recordkeeping
and reporting program to verify that the information recorded and reported
is thorough, accurate, and consistent with information contained in local
records.
Attachment 1 DOE M 231.1-1A Chg 2
Page 4 6-12-07
Vertical line denotes change.
c. At a facility or site where DOE regulates worker safety and health, the contractor
must ensure that reports for work-related fatalities, injuries, and illnesses to
employees of subcontractors who employ 11 or more employees on the DOE
work being performed, and who do not meet the criteria in paragraph d(2) below,
are recorded in accordance with 29 CFR 1904.4 through 1904.11, 1904.29
through 1904.33 and 1904.46. Reports of recordable injuries and illnesses to
subcontractor employees are reported separately for each subcontractor
organization in the same manner as described in paragraphs 3b(2) and 3b(3)
above for contractor employees, unless consolidation of data is approved by the
CAIRS Point of Contact for the Head of the Headquarters Element or their
designated CAIRS POC at the DOE field organization. Procedures for adding or
deleting organization codes to accommodate changes in reporting organizations
are contained in Appendix E to DOE M 231.1-1A.
Section 13
d. At a facility or site where DOE regulates worker safety and health, the contractor
must ensure that work-related fatal and non-fatal injury and illness cases to
subcontractor employees meeting the recording criteria in 29 CFR 1904.4 through
1904.11 and that satisfy either of the two conditions below are submitted
according to paragraph 3e below. These cases are not factored into the
contractor’s injury and illness incidence rates of recordable cases. The two
conditions are:
(1) The subcontractor employs a total of 10 or fewer employees (including
direct hires and those hired through subtier contracts) on the DOE work
being performed, or
(2) The DOE work being performed meets all of the following conditions:
(a) the work being performed by the subcontractor is limited to
transient activities,
(b) the subcontractor does not maintain an onsite office, and
(c) the subcontractor does not receive direction/oversight from DOE
or a DOE contractor (e.g., copy machine repair, express mail
delivery, telephone installation/repair, vending machine service).
e. Unless otherwise approved by the Head of the Headquarters Element or their
designated point of contact for the DOE Field organization, the contractor will
ensure that recordable work-related injury and illness reports are submitted for
employees of subcontractors covered by either of the two conditions in paragraph
3d above according to the following requirements:
(1) Within 7 calendar days of receiving information that an injury or illness
has occurred, an injury/illness report will be submitted to CAIRS by using
CAIRS Direct Data Entry. [NOTE: These injury/illness reports, which
DOE M 231.1-1A Chg 2 Attachment 1
6-12-07 Page 5
Vertical line denotes change.
the CAIRS Accident Type will be identified as “non-reportable” (NR) are
not factored into the contractor’s injury/illness rates of recordable cases
and are available to select CAIRS users for information purposes.
Incidence rates and summary information available to CAIRS general
users are based on reports of recordable injury and illness cases that meet
the recording criteria established in 29 CFR 1904 and which the Accident
Type is identified as either “Injury” or “Illness.”]
(2) The injury/illness report, which can be submitted partially complete, must
contain the following data elements as described in Appendix C.
(a) Organization code (See Appendix E for additional information.)
(b) Sub-level code (see Appendix E for additional information.)
(c) Case Number
(d) Date of Injury/Illness
(e) Specific Location
(f) Last Name of Employee
(g) First Name of Employee
(h) Activity Description
(i) Event Description
(j) Nature Description
(k) Body part injured
(l) Person completing form
(m) Accident Type (Accident type must be identified as either a non-
reportable injury or a non-reportable illness).
f. Ensure that new reports (DOE F 5484.3) are submitted at least twice per month
for receipt on or before the 15th of the month and the last working day of the
month. Initial reports will include the actual work time lost as of the date the
report is submitted. Revisions to lost work time will be submitted quarterly until
the case is closed. Quarterly revisions for lost work time and any other
information that requires revising information initially reported, will be submitted
for receipt by the 10th of the month following the end of the calendar quarter (i.e.,
April 10th, July 10th, October 10th, and January 10th). Prior to the transition to
require electronic reporting only, legible copies of completed report forms may be
mailed. Mailed report forms should be addressed to the CAIRS Data Coordinator,
Section 14
Attachment 1 DOE M 231.1-1A Chg 2
Page 6 6-12-07
Vertical line denotes change.
U.S. Department of Energy, HS-30/Bldg. 270 CC, 1000 Independence Ave.,
S.W., Washington, DC 20585-0270. Effective 180 days following the addition of
this requirement to the contract, DOE F 5484.3 will be submitted electronically
only, using either CAIRS Bulk Upload Processing or by entering information into
the electronic form using CAIRS Direct Data Entry.
g. Ensure that quarterly work-hours are submitted by the 10th of the month
following the end of the quarter (e.g., first quarter CY reports are due April 10).
Prior to the transition to require electronic reporting only, legible copies of
completed report forms (DOE F 5484.4) may be mailed. Mailed report forms
should be addressed to the CAIRS Data Coordinator, U.S. Department of Energy,
HS-30/Bldg. 270 CC, 1000 Independence Ave., S.W., Washington, DC
20585-0270. Effective 180 days following the addition of this requirement to the
contract, DOE F 5484.4 will be submitted electronically only, by entering
information into the electronic form using CAIRS Direct Data Entry. Additional
information about accessing CAIRS and electronic report submission is included
in Appendix E of DOE M 231.1-1A and on the Internet at the R&R References
and Resources Web page (http://www.hss.energy.gov/csa/csp/cairs/refs.html).
h. Ensure that the OSHA Form No. 300A is completed, certified, and posted in the
workplace annually. (See requirements in 29 CFR 1904.29, 1904.32, and
1904.44.)
i. Accident and related records must be retained, maintained and accessible as
follows.
(1) A contractor newly assuming occupational safety and health
responsibilities for DOE work being performed must accept and maintain
already existing records of a prior contractor. A contractor with an
expiring or terminating contract must transfer records to the facilities
management or follow-on contractor. [See record retention requirements
in 29 CFR 1904.33.]
(2) The contractor must ensure that access to accident records is as follows.
(a) An employee, former employee, and/or his/her representatives
have the right to limited access of the OSHA Form No. 300 that
contains the employee’s name.
(b) Access is subject to the Privacy Act, section 5 U.S.C § 552a and
the Freedom of Information Act (FOIA) requirements and
restrictions. [See 5 U.S.C. 552(b)(6).] Access to information on
any log maintained by a DOE contractor as described in this CRD
will be restricted to information that does not constitute an
unwarranted invasion of personal privacy. An employee whose
DOE M 231.1-1A Chg 1 Attachment 1
6-12-07 Page 7
Vertical line denotes change.
name does not appear on a log will be limited to accessing
information that does not identify any injured or ill employees, and
will not be provided access to the names of the injured or ill
employees. An employee, former employee, and/or an authorized
representative will have access to DOE F 5484.3 data that contains
the employee’s name.
(c) Records listed in 29 CFR 1904.4 and 1904.5 (or the DOE
equivalent of these records) must be made available for inspection
and copying by any Department of Energy representative for the
purpose of conducting oversight assessments or for statistical
compilation.
(3) Ensure that OSHA Form No. 300 is updated [see 29 CFR 1904.33]. Each
quarter for at least one year from the date of the injury/illness, ensure that
each DOE F 5484.3 that includes lost work time (either days away from
work or days restricted/transferred) is updated to indicate changes in lost
work time or changes in the description or outcome of the case.
Section 15
(4) Ensure that individuals tasked with occupational injury and illness
recording and reporting responsibilities are appropriately trained to
accomplish the recording and reporting requirements of this CRD and are
informed to contact the Office of Corporate Safety Analysis for additional
information and assistance in interpretation of requirements contained in
this CRD.
4. ANNUAL FIRE PROTECTION SUMMARY. Ensure that the computer-based
application provided by the Chief Health, Safety and Security Officer is utilized for
submitting formatted annual summaries of the fire protection information by April 30 of
the following year [see Appendix F of DOE M 231.1-1A].
5. EPIDEMILOGIC ANALYSES—EXCESS INJURIES AND ILLNESSES. Ensure that
the following reporting requirements for excessive injuries and illnesses are followed:
a. Notify the Head of the Field Element of suspected excessive illnesses or injuries
that require epidemiologic investigation. Excessive illness or injury means the
perception that an unusually high number of cases may be occurring among a
group of workers. Epidemiologic analyses can help determine whether suspected
illness or injury excesses are greater than expected and are associated with
working conditions.
b. Ensure that employees are aware that any worker, individual, or group (e.g.,
safety and health staff, supervisors, or employee representatives) can identify
suspected illness or injury excesses.
Attachment 1 DOE M 231.1-1A
Page 8 3-19-04
6. EPIDEMILOGIC ANALYSES—OSH STUDIES. The contractor must ensure DOE
authorized investigators, including investigators from the Department of Health and
Human Services (DHHS) and Centers for Disease Control and Prevention are provided
access to DOE facilities, workers, (contractors and subcontractors), information, and data
needed for epidemiologic research projects and related activities addressing worker and
community health. Research may require medical test, work place surveys, and review of
personnel, medical and exposure records. All investigators are required to comply with
Privacy Act and security requirements.
7. RADIATION EXPOSURE REPORTS TO THE RADIATION EXPOSURE
MONITORING SYSTEM (REMS) REPOSITORY. Ensure that the following
requirements for radiation exposure monitoring reports are followed:
a. Annual Individual Radiation Exposure Records.
(1) DOE contractors will report annual radiation exposure records required by
10 CFR 835.702(a) and (b) to the REMS repository by March 31 for the
preceding monitoring year. The records should include exposure records
for special individuals as described in paragraph 1b(1) of this chapter.
(2) Revisions to radiation exposure records for monitoring periods beginning
on or after January 1, 1989, will be reported to the REMS repository.
Revised records for prior monitoring years will be submitted annually by
March 31. However, if the revised dose record results in a dose exceeding
regulatory dose limits defined in 10 CFR 835.202, revised records will be
submitted within 30 days of the date that the dose record is revised.
Revised records should be submitted to the REMS repository in a separate
file, but in the same format as annual records. The transmittal
documentation should note that the enclosed records are revised.
b. Radiation Exposure Records for Special Individuals.
Section 16
(1) A special individual is a person employed by DOE Headquarters, a
contractor supporting DOE Headquarters or Field Office activities, a
Defense Nuclear Facilities Safety Board employee or contractor, or an
International Atomic Energy Agency inspector who visits a DOE or DOE
contractor site or facility to conduct Department-related business.
Radiation exposure data pertaining to special individuals will be reported
to the REMS repository within 30 days after the determination of the
dosimetry.
(2) Each DOE contractor employee or a special individual who visits in an
official capacity, a radiological site outside of the DOE shall arrange to
have all pertinent occupational radiological exposure data to his or her
employer within 30 days after determination of the dosimetry.
DOE M 231.1-1A Attachment 1
3-19-04 Page 9 (and Page 10)
(3) DOE contractors shall ensure that such procedures exist and are effective
in support of paragraph 1b(2) above.
c. Report Format. All radiation exposure reports sent to the REMS repository as
noted in paragraphs 1a and 1b must be submitted in electronic format and must be
prepared in accordance with Appendix G of this Manual.
d. Exposure Reports to Individuals. Reports to individuals must be prepared in
accordance with 10 CFR 835.801.
DOE M 231.1-1A Appendix A
3-19-04 A-1
APPENDIX A. ACRONYMS
ASP Active server pages
CAIRS Computerized Accident/Incident Reporting System
CBUP CAIRS Bulk Upload Processing
CDC Centers for Disease Control and Prevention
CDDE CAIRS Direct Data Entry
CDE Committed dose equivalent
CFR Code of Federal Regulations
CRD Contractor Requirements Document
CSO Cognizant Secretarial Office
CY Calendar year
DART Days away from work, days of restricted work activity or job transfer
DDE Deep dose equivalent
DHHS Department of Health and Human Services
DOE Department of Energy
ES&H Environment, Safety and Health
FOIA Freedom of Information Act
ICRP International Commission on Radiological Protection
LDE Dose to lens of the eye
LPSO Lead Program Secretarial Office
LSRC Leaks, spills, releases or contamination
NAICS North American Industry Classification System
NEPA National Environmental Policy Act
NNSA National Nuclear Security Administration
OBD Operational basis document
ORPS Occurrence Reporting and Processing System
OSH Occupational Safety and Health
OSHA Occupational Safety and Health Administration
PSE Planned special exposure
PTT Permanent transfer or termination
Appendix A DOE M 231.1-1A
A-2 3-19-04
REMS Radiation Exposure Monitoring System
SDE-LL Shallow dose equivalent—lower left extremity
SDE-LR Shallow dose equivalent—lower right extremity
SDE-UL Shallow dose equivalent—upper left extremity
SDE-UR Shallow dose equivalent—upper right extremity
SDE-WB Shallow dose equivalent—whole body
SIC Standard Industrial Classification System
SOC Standard Occupational Classification
SSL Secure socket layer
TEDE Total effective dose equivalent
DOE M 231.1-1A Appendix B
3-19-04 B-1 (and B-2)
APPENDIX B. OSHA FORMS 300 AND 300A
The list below contains categories of information reported on OSHA Form 300, Log of
Work-Related Injuries and Illnesses, and OSHA Form No. 300A, Summary of Work-Related
Injuries and Illnesses. Both forms and instructions for calculating incidence rates [total
recordable cases and recordable cases involving days away from work, days of restricted work
activity, or job transfer (DART)] can be downloaded, copied, and printed from the OSHA
Recordkeeping Internet site. The OSHA Homepage can be accessed at http://www.osha.gov.
Section 17
1. OSHA Form No. 300.
Establishment name
Establishment address: (street address, city, state, and zip code)
Case number
Employee’s name
Job title
Date of injury or onset of illness
Where the event occurred
Description of injury or illness, body parts affected, and object/substance that
directly injured or made person ill
Case classification
Number of days on job transfer or restriction
Number of days away from work
Type of injury or illness
2. OSHA Form No. 300A.
Number of cases. CY total of the following: deaths, cases with days away from
work, cases with job transfer of restriction, and other recordable cases.
Number of days. CY total of the following: days of job transfer or restriction and
days away from work.
Injury and illness type. CY total of each type of case.
Establishment Information. Name of the establishment, the complete street
address, industry description, SIC/NAICS.
Employment information. Annual average number of employees, and the total
hours worked by all employees last year.
Signature: Company executive signs, certifying the log, title, phone number and
date signed.
DOE M 231.1-1A Chg 2 Appendix C
6-12-07 C-1
Vertical line denotes change.
APPENDIX C. INDIVIDUAL ACCIDENT/INCIDENT REPORT—DOE F 5484.3
1. INSTRUCTIONS. The information in Table C-1 provides guidance for filling out DOE
F 5484.3, Individual Accident/Incident Report.
Table C-1. Individual Accident/Incident Report Data Elements.
Data Element Example/Format Instructions
Organization Code 1504001 Indicate the seven-digit number that has been assigned
to the specific reporting organization submitting the
accident report. [NOTE: A Standard Industrial
Classification code (SIC) or North American Industry
Classification System (NAICS) code will be linked to
each organization code. The SIC coding system is
being replaced by the NAICS. ]
Sub-level Code E1234567 Enter the eight character identifier that has been
assigned to the organization code to denote a sub-level
reporting group. The default (00000000) denotes that
this organization is not a sub-level group.
CASE Number 125 Enter the case number from the log for injury/illness
cases. Case numbers for a given reporting
organization must be unique within a given year.
Multiple-Organization Case No (default) Enter Yes or No to indicate whether the case involves
two or more reporting organizations.
Multiple-Case Number 5 Enter a number or code to represent any common
accident that involves more than one recordable case.
Use the same code on each of the separate forms.
Accident Type Injury Select the appropriate accident type. Possible entries
are: Injury, Illness, Non-Recordable Injury,
Non-recordable Illness, Non-Reportable (NR).
Investigation Type C Select the appropriate investigation type. Possible
entries are A, B, C, NR, where Type A and Type B refer
to Board investigations as defined in the current version
of DOE O 225.1A. Type C refers to the level of
investigation required for other recordable injury and
illness cases to complete DOE F 5484.3. Type NR is
used when a previously reported case has been
revised to non-recordable status.
Department, Division, or ID
Code
Maintenance Enter the Department, Division, or ID code as desired.
Date of Injury/Illness 20021205 Enter the date of the injury or onset of illness in the
required format (YYYYMMDD)
Time of Accident/Event
Known
Section 18
Yes Enter Yes or No in answer to the question, “Is the time
of event known?” The default value is Yes.
Time of Accident/Event 13 Enter time of accident/event, as local time, to the
nearest hour using the first two digits of the 24-hour
clock (e.g., 1:00 PM is 13 for 1300).
Appendix C DOE M 231.1-1A Chg 2
C-2 6-12-07
Table C-1. Individual Accident/Incident Report Data Elements (continued).
Vertical line denotes change.
Data Element Example/Format Instructions
Time Employee began Work 13 Enter the time the employee began work, as local time,
to the nearest hour using the first two digits of the 24-
hour clock (e.g., 1:00 PM is 13 for 1300).
Accident Place Indoor Select the appropriate choice to indicate whether the
accident occurred indoors or outdoors. Optional data
field.
Employers Premises No Enter Yes or No to indicate whether the accident
occurred on the employer’s premises. Optional data
field.
Specific Location Bldg. C, Test Area B Enter the specific location of the accident (e.g., street
address, name of building or laboratory).
Last Name Jones Enter the employee’s last name.
First Name John Enter the employee’s first name.
Middle Name or Initial Adams Enter the employee’s middle name or initial.
Home address of injured or ill
person
120 S 35th St. Maui, HI
99999
Enter the employee’s full address (street, city, state, zip
code).
ID Number 999999999 Enter an employee ID number. This number can be up
to 9 characters. Do NOT use social security numbers.
Date of Birth 19671205 Enter the employee’s date of birth in the format
YYYYMMDD.
Gender Male Select the appropriate box to indicate the gender.
Occupation Code 203 Enter the generic occupation code that most closely
indicates the employee’s occupation. A list of
occupation codes is available in the CAIRS Direct Data
Entry Reference Manual, which can be found on the
Internet Web page
http://www.hss.energy.gov/csa/csp/cairs/refs.html.
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Job Title Senior Scientist Enter the employee’s job title.
Name of health care provider Dr. John Doe Enter the name of the employee’s physician or other
health care professional.
Emergency Room No Enter Yes or No to indicate whether the employee was
treated in an emergency room.
Name and Address of
treatment facility
Memorial Hospital
125 E 19th Street Maui,
HI 99999
Enter the name and address of the offsite treatment
facility.
Hospitalized overnight? No Enter Yes or No to indicate whether the employee was
hospitalized overnight as an in-patient.
Length of employment over 12 months Select the appropriate box that indicates the
approximate length of employment: under 3 months, 3
to 12 months, over 12 months. Optional data field.
DOE M 231.1-1A Chg 2 Appendix C
6-12-07 C-3
Table C-1. Individual Accident/Incident Report Data Elements (continued)
Vertical line denotes change.
Data Element Example/Format Instructions
Experience on this job or
equipment
3 to 12 months Select the appropriate box that indicates the
approximate length of experience on job or equipment
being used at the time of the accident: under
3 months, 3 to 12 months, over 12 months.
OSHA Classification Injury Select the appropriate box to choose injury or one type
of illness. [NOTE: Illness types identified on OSHA
Form 300.]
Days Away from Work Up to 4 digit number Enter the number of days the injured or ill employee
was away from work.
Section 19
Days Restricted/ transferred Up to 4 digits Enter number of days the injured/ill employee was on
job transfer or restriction.
Death Yes Enter Yes or No to indicate if the injury/illness resulted
in death.
Date of Death (YYYYMMDD) Enter the date (YYYYMMDD) if death occurred.
Permanent Transfer Yes Enter Yes or No to indicate if injured/ill employee was
given a permanent transfer to a different job because of
a disability arising from the accident. Optional data
field.
Termination No Enter Yes or No to indicate if injured/ill employee was
terminated because of a disability arising from the
accident. Optional data field.
Primary material, object, or
substance involved in the
accident (Source)
4 digits Enter the appropriate code to indicate the primary
material, object, or substance involved in the accident.
A list of “Source, Target, Other Equipment” codes is
available in the CAIRS Direct Data Entry Reference
Manual, which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Other Material, object or
substance involved in the
accident
4 digits Enter the appropriate code for other material, object, or
substance involved in the accident. A list of “Source,
Target, Other Equipment” codes is available in the
CAIRS Direct Data Entry Reference Manual, which can
be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Equipment design or defect
Yes Enter Yes or No to indicate whether the equipment
design or defect contributed to the accident cause or
severity.
Direct Cause Employee Select the appropriate choice that indicates the direct
cause of the accident. Possible entries are: weather,
design/material, procedures, employee, other/none of
the above. Optional data field.
Appendix C DOE M 231.1-1A Chg 2
C-4 6-12-07
Table C-1. Individual Accident/Incident Report Data Elements (continued).
Vertical line denotes change.
Data Element Example/Format Instructions
Indirect Cause Up to 8 characters Select the appropriate choice that indicates the indirect
cause of the accident. Possible entries are: weather,
design/material, procedures, employee, other/none of
the above. Optional data field.
Loss producing event 4 digits Enter the appropriate code to indicate the source for
injury/illnesses cases. A list of “Loss Producing Event”
codes is available in the CAIRS Direct Data Entry
Reference Manual, which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Body part injured 4 digits Enter the appropriate code to indicate the body part
injured. A list of “Body Parts” codes is available in the
CAIRS Direct Data Entry Reference Manual, which can
be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Injury/Illness Type (Nature) 4 digits Enter the appropriate code to indicate the injury/illness
type. A list of “Nature of Injury/Illness” codes is
available in the CAIRS Direct Data Entry Reference
Manual, which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Section 20
Personal Protective
Equipment Used
4 digits Enter the appropriate code to indicate the personal
protective equipment used by the employee at the time
of the accident. A list of “Personal Protective
Equipment” codes is available in the CAIRS Direct Data
Entry Reference Manual, which can be found on the
Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Activity Code 4 digits Enter the appropriate code to indicate the activity in
progress at the time of the accident. A list of “Activity”
codes is available in the CAIRS Direct Data Entry
Reference Manual, which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Optional data field, if left blank, this information may be
coded by a Data Specialist if the information is provided
in the report.
Date of Hire 8 digits Enter the date of hire (YYYYMMDD).
DOE M 231.1-1A Chg 2 Appendix C
6-12-07 C-5
Table C-1. Individual Accident/Incident Report Data Elements (continued)
Vertical line denotes change.
Program Office 2 characters Select the Headquarters program office route symbol to
identify the office responsible for the work activity in
progress at the time of the accident. A list of program
office codes is available in the CAIRS Direct Data Entry
Reference Manual, which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Implementation Date 20021204 Enter the implementation date for recommended
corrective actions (YYYYMMDD).
Person Completing Form Up to 40 characters Enter the name of person who completed the form.
Phone Number for Person
Completing Form
Up to 12 characters Enter the phone number of the person who completed
the form.
Date of signature of person
completing form
8 characters Enter the date the form was completed.
Job title of person completing
form
Up to 40 characters Enter the job title of the person who completed the
form.
Supervisor responsible for
Corrective Action
Up to 40 characters Enter the name of supervisor responsible for corrective
action. Optional data field.
Supervisor’s phone number
12 characters Enter the phone number for the supervisor responsible
for corrective actions. Optional data field.
Date of signature of
supervisor
8 characters Enter the date of signature for supervisor responsible
for corrective actions. Optional data field.
Accident Investigation
Contact
Up to 40 characters Enter the name of the person to contact if different from
person completing form. Optional data field.
Accident Investigation
Contact Phone Number
12 characters Enter phone number of accident investigator. Optional
data field.
Activity Description Free form text
Example: Climbing a
ladder while carrying
roofing materials.
Enter a description of what activity was in progress just
before the accident occurred. Describe the activity as
well as the tools, equipment, or material the employee
was using. Be specific.
Corrective Actions Taken Free form text Enter a description of the actions taken to prevent
reoccurrence of accident/incident.
Corrective Actions
Recommended
Free form text Enter recommended corrective actions.
Employee Actions Free form text
Example: Employee
overloaded the utility cart
with trash bags.
Enter a description of actions on the part of the
employee that contributed to the occurrence of the
accident.
Section 21
Conditions that existed at the
time of the accident
Free form text Enter a description of the conditions that existed at the
time of the accident.
Appendix C DOE M 231.1-1A Chg 2
C-6 6-12-07
Table C-1. Individual Accident/Incident Report Data Elements (continued).
Vertical line denotes change.
Data Element Example/Format Instructions
Event description (What
happened?)
Free form text Enter a description of what happened to cause the
injury or illness, in order of sequence, beginning with
the initiating event, and followed by the secondary and
tertiary events.
Nature description (What was
the injury or illness?)
Free form text Enter a description of the nature and extent of
injury/illness, part of body affected, and how it was
affected. Be more specific than “hurt,” “pain,” or “sore.”
Influencing Factors or
causes, that contributed
Free form text Enter factors influencing underlying causes, either
conditions or actions or both, that contributed to the
accident/incident.
Material/Object/Substance Free form text
Examples: concrete floor;
chlorine; radial arm saw
Lists any materials, objects or substances involved that
directly harmed the employee. If this does not apply to
the incident, leave it blank.
Is the case closed? Yes Enter Yes or No to indicate whether the case is closed
(no additional lost work time is anticipated).
DOE M 231.1-1A Chg 1 Appendix D
6-12-07 D-1
Vertical line denotes change.
APPENDIX D. TABULATION OF WORK HOURS—DOE F 5484.4
1. DATA ELEMENTS. The guidelines in Table D-1 apply to tabulating work hours.
Table D-1. Tabulating Work Hours.
Data Element Example/Format Instructions
Organization code 1504001 Indicate the seven-digit number that has been
assigned to the specific reporting organization
submitting the accident report.
Organization Name DOE Headquarters Name of the reporting organization.
Calendar Year 2003 Select the appropriate calendar year (YYYY) for the
reporting period.
Reporting Quarter 1—Jan. through March
2—Apr. through June
3—July through Sept.
4—Oct. through Dec.
Select the appropriate calendar quarter for the
reporting period.
Hours worked 12 characters Include hours worked by salaried, hourly, part-time
and seasonal workers, as well as hours worked by
other workers subject to day-to-day supervision by
your organization (e.g., temporary help services
workers). Do not include vacation, sick leave,
holidays, or any other non-work time, even if
employees were paid for it. If your organization keeps
records for only the hours paid or if you have
employees who are not paid by the hour, estimate
hours that the employees actually worked. If actual
hours worked are not available, use the method in
paragraph 2 of this appendix to estimate total hours
worked.
PSO 3 characters Enter Headquarters program offices responsible for
employee hours being reported. Estimate the
percentage of work done by each organization (if more
than one). A list of program office codes is available
in the CAIRS Direct Data Entry Reference Manual,
which can be found on the Internet
(http://www.hss.energy.gov/csa/csp/cairs/refs.html).
Quarterly Report Complete Yes After entering hours worked for the reporting period,
click “Yes” or “No” to indicate that all new and revised
accident reports have been entered for the reporting
period.
Appendix D DOE M 231.1-1A
D-2 3-19-04
2. INSTRUCTIONS FOR ESTIMATING HOURS WORKED. If the actual number is not
available, you can estimate hours worked using the following formula.
Section 22
Find the number of full-time employees for your organization for the quarter:
Multiply by the number of work hours for a full-time employee in the quarter: X
This is the number of full-time hours worked during the quarter. =
Add the number of any overtime hours and the hours worked by
other employees (part-time, temporary, seasonal) during the quarter. +
Round the total to the next highest whole number =
This number is the estimated total hours worked by all employees during the quarter.
DOE M 231.1-1A Chg 2 Appendix E
6-12-07 E-1
Vertical line denotes change.
APPENDIX E. ACCESSING CAIRS AND OBTAINING ORGANIZATION CODES
1. ACCESSING CAIRS.
The Computerized Accident/Incident Reporting System (CAIRS) offers electronic access
to summary information on accidents reported by DOE and DOE contractor organization.
a. Registration.
CAIRS is a Government computer system and, as such, has cyber security
requirements that must be followed. These security requirements are mandated
by DOE O 205.1, Department of Energy Cyber Security Management Program,
dated 3-21-03. Some of the information contained in CAIRS is restricted and is
to be accessed by authorized users for official Government business only.
Registered users of CAIRS agree to adhere to the security requirements specified
on the registration form. Individuals interested in registering to become CAIRS
users can obtain a copy of the registration form from the HSS Infocenter at (800)
473-4375.
b. System Requirements. The following are the system requirements for using
CAIRS. You must have—
an Internet connection (either direct or via an ISP); an Ethernet connection
to DOE’s Business Network, or a modem capable of communicating at
speeds of 28,800 BPS or faster;
a Pentium or faster computer with sufficient memory to support a Web
browser such as Netscape or Internet Explorer (As with all Windows
applications, a faster PC and/or additional memory will greatly enhance
system performance.
Netscape 4.0 or higher or Internet Explorer 4.0 or higher in order to
support features such as tables, Secure Socket Layer (SSL-2) protocol, and
Active Server Pages (ASP).
Windows 95 or higher.
2. OBTAINING ORGANIZATION CODES AND SUB-LEVEL CODES.
An organization code is a 7-character identifier assigned for the purpose of CAIRS
reporting and for managing records in the database. Each part of the code has a specific
meaning. The first two characters specify the field organization (such as Idaho
Operations). The third character specifies an area office (if there are any under the field
office). The fourth through sixth characters specify the DOE or DOE contractor
Appendix E DOE M 231.1-1A Chg 2
E-2 6-12-07
Vertical line denotes change.
organization. The seventh character represents an operation type such as production,
research, government, etc.
A sub-level code is an eight character identifier that is assigned to the organization code
to denote a sub-level reporting group. The first character is reserved for data
management purposes. The second through eighth characters specify the sub-level
group.
Changes in organization codes and sub-level codes must be approved by the CAIRS
Point of Contact (POC) for the Cognizant Secretarial Officer or their designated CAIRS
Point of Contact at the DOE field organization and the CAIRS Program Manager.
Requests for changes in organization code should be initiated through the HSS Infocenter
at (800) 473-4375 or by sending e-mail to CAIRS support at
HSS_Infocenter@hq.doe.gov.
Section 23
3. ELECTRONIC REPORTING.
The Computerized Accident/Incident Reporting System (CAIRS) allows two methods of
electronically submitting reports, CAIRS Direct Data Entry (CDDE) and CAIRS Bulk
Upload Processing (CBUP). Access to the electronic reporting features in CAIRS is
controlled. CDDE is an internet-based tool that takes advantage of the modern browser
technology currently being used to navigate the World Wide Web (WWW). It allows
users capabilities to enter new cases, edit previously saved cases and retrieving relevant
data using features consistent with the current Windows environments found on most of
today’s personal computers. CBUP allows organizations with local computer systems
that contain information needed to complete accident reports, capabilities to extract the
required data fields from the local computer and transfer a data file containing this
information to CAIRS. To register to begin electronic reporting or for additional
information contact the HSS Infocenter at (800) 473-4375 or by sending e-mail to CAIRS
support at HSS_Infocenter@hq.doe.gov. The CAIRS reference documents listed below
are available online at: http://www.hss.energy.gov/csa/csp/cairs/refs.html.
CAIRS Reference Manual
CAIRS Direct Data Entry Manual
CAIRS Direct Data Entry Training Package
DOE M 231.1-1A Appendix F
3-19-04 F-1
APPENDIX F. ANNUAL FIRE PROTECTION SUMMARY
1. SUMMARY OF FIRE LOSS DAMAGE INCIDENTS.
Fire loss includes property damage or loss sustained as a consequence of a fire. Fire loss
is deemed reportable based upon the fire department incident report. If the event results
in a dispatch, fire department response, and classification as a fire event, then the loss is
considered to be reportable.
Each fire loss event will include separate entries or fields for the following information.
NOTE: Reporting elements may submit electronic copies of incident logs, provided that
such information complies with all required reporting attributes of the National Fire
Incident Reporting System (NFIRS).
a. Date, location, dollar amount of loss, and incident description. The event
description should include remedial actions taken to prevent event recurrence.
Criteria for estimating damage costs are provided as paragraphs 8 and 9 below of
this Appendix.
b. Incidents, classified as—
Fire/Smoke [Building],
Fire/Smoke [Brush],
Fire/Smoke [Vehicle], or
Fire/Smoke [Other]
c. Causal factor(s) associated with the event, classified as—
Weather Related,
Employee Related
Procedure Related,
Other, or
Unspecified.
d. Involvement of a fixed suppression system. Include the system type, method of
actuation, the number of sprinkler heads activated (water-based suppression
systems) or the quantity of agent discharged (nonwater-based suppression
systems).
e. Related deaths or injuries resulting from this event.
f. A cross-reference to other DOE reports such as entries in the Occurrence
Reporting and Processing System (ORPS), the Computerized Accident/Incident
Reporting System (CAIRS) or local incident logs.
Appendix F DOE M 231.1-1A
F-2 3-19-04
2. NON-FIRE INCIDENTS ACTUATING AUTOMATIC FIRE SUPPRESSION
SYSTEMS.
Suppression system actuation can occur from fire or other loss events and are categorized
as such to account for total property loss. Please see paragraph 1 above for information
on determining fire loss and including an event description for incidents involving
automatic suppression systems. Other losses include damage or loss sustained as a
consequence of one of the following events:
Section 24
explosion;
natural causes (such as earthquakes and hurricanes);
electrical malfunction (not classified as fire);
transportation (cargo) loss;
mechanical malfunction; or
radiation release or other nuclear accident, miscellaneous accidents (such as
thermal, chemical, or corrosion-related accidents).
Summaries should include information on the actuation of any automatic suppression
systems to identify and prevent recurrence.
Each incident resulting in the actuation of an automatic fire suppression system will
include separate entries or fields containing the following information.
a. The date, location, dollar amount of loss, and incident description. The event
description should include remedial actions taken to prevent recurrence. Criteria
for estimating damage costs are provided in paragraphs 8 and 9 of this Appendix.
b. Incident classified as—
Fire/Smoke [Building],
Fire/Smoke [Brush],
Fire/Smoke [Vehicle], or
Fire/Smoke [Other]
c. Causal factor associated with the event, classified as—
Weather Related,
Employee Related,
Procedure Related,
Other, or
Unspecified.
DOE M 231.1-1A Chg 2 Appendix F
6-12-07 F-3
Vertical line denotes change.
d. Involvement of a fixed suppression system. Include the system type, method of
actuation, the number of sprinkler heads activated (water-based suppression
systems) or the quantity of agents discharged (nonwater-based suppression
systems).
e. Related deaths or injuries resulting from this event.
f. A cross-reference to other DOE reports such as entries in ORPS, the
Computerized Accident/Incident Reporting System or local incident logs.
3. HALON REDUCTION ACTIVITIES.
a. Fixed Systems.
(1) Number of systems from previous reporting year _______
(2) Number of systems removed from service this period. _______
Include fixed, manually actuated, mobile or skid
mounted systems that have been placed in inventory.
(3) Number of systems placed in service this period. _______
Include active system transfers between sites as
well as systems that may have been temporarily
placed in inventory.
(4) TOTAL NUMBER OF ACTIVE SYSTEMS
THIS REPORTING YEAR _______
(5) Active system quantity from previous reporting
year (Active systems are defined as those currently
installed to suppress a fire and includes reserve
capacity in a two-shot system. _______
(6) Quantity placed in service within the past year. _______
Include quantities of fixed, manually actuated, mobile
or skid mounted systems that have been placed in inventory.
(7) Quantity removed from service within this period. _______
Include quantities of fixed, manually actuated, mobile
or skid mounted systems that have been placed in inventory.
(8) Quantity released this period through leakage
or actuation. _______
Appendix F DOE M 231.1-1A
F-4 3-19-04
(9) TOTAL QUANTITY OF ACTIVE SYSTEMS
THIS REPORTING YEAR _______
(10) Halon inventory from previous reporting year. _______
(11) Quantity added to inventory from item (7) above _______
(12) Quantity imported to inventory from other sites. _______
(13) Quantity exported offsite (banked). _______
(14) Quantity sold or excessed. _______
(15) TOTAL QUANTITY OF HALON INVENTORY
THIS REPORTING YEAR. _______
b. Hand-Held Halon Extinguishers.
(1) Active quantity from previous reporting year _______
(2) Quantity removed from service within this period. _______
(3) TOTAL QUANTITY OF ACTIVE HAND-HELD HALON
EXTINGUISHERS THIS REPORTING THIS
REPORTING YEAR. _______
Section 25
(4) Halon inventory from previous reporting year. _______
(5) Quantity added to inventory from item (2) above. _______
(6) Quantity exported offsite (banked). _______
(7) Quantity sold or excessed. _______
(8) TOTAL QUANTITY OF HAND-HELD HALON
EXTINGUISHER INVENTORY THIS
REPORTING YEAR. _______
4. FIRE PROTECTION INSPECTION TESTING AND MAINTENANCE ACTIVITIES.
a. System Summary. Identify the type and number of systems inspected, tested, or
maintained at the site this reporting period. Compare summary with the previous
reporting period to determine any system summary modifications that may have
taken place over the year. System types are identified in Table F-1.
DOE M 231.1-1A Appendix F
3-19-04 F-5
b. All failures of fire protection systems (sprinkler systems, fire alarm systems, etc.)
should be reported annually. Failure in this context is the inability to meet at least
one of the operability requirements established for the system as part of the
inspection, testing, and maintenance program. (Refer to DOE O 420.1A, Facility
Safety, dated 5-20-02.) Summaries should be provided for each system type at the
site. System types are identified in Table F-1.
Table F-1. Fire Suppression System Types.
Code Description
1A Wet Pipe Sprinkler System
1B Dry Pipe Sprinkler System
1C Deluge Sprinkler System
1D Pre-Action Sprinkler System
1E Foam-Water System
1F Water Spray System
1G Halon 1301 Systems
1H Halon 1211 Systems (Fixed)
1I Clean Agent Systems
1J Wet Chemical Systems
1K Dry Chemical Systems
1L Carbon Dioxide Systems
1M Other Fixed Water Application Equipment
1N Fire Pumps
1O Central Fire Alarm
1P Local Fire Alarm Systems
5. FIRE DEPARTMENT ACTIVITIES.
a. Number of Responses.
(1) Fire _______
(2) HAZMAT Response _______
(3) Other Emergency _______
(4) Non-Emergency _______
(5) Medical _______
(6) Mutual Aid Responses _______
Appendix F DOE M 231.1-1A
F-6 3-19-04
Identify and classify all fire department response events. For this reason, each response
should be recorded in a single fire department incident report from the first due or
incident commander’s perspective.
The fire response category relates to working fires on the site that were either
extinguished or verified as a fire event by the responding incident commander.
HAZMAT response relates non-fire hazardous material incidents. The other emergency
category is intended for all other emergencies in which firefighting apparatus was
dispatched, including offsite mutual aid response, or support for a medical response.
The non-emergency category relates to situations where the initial response was
considered an emergency, but was later verified as a non-emergency by the incident
commander. This includes inadvertent system actuation. Malicious alarms or offsite
mutual aid that was cancelled en route. Medical response includes any response in which
an ambulance was dispatched for the sole purpose of a medical emergency.
b. Major equipment purchases. Describe type of equipment and purchase price.
c. Notable response descriptions not already included in the report.
6. RECURRING FIRE PROTECTION PROGRAM COSTS.
a. Fire Department Costs.
(1) Staffing
(2) Equipment
(3) System Inspection and testing and Maintenance costs
(4) Emergency medical response costs
(5) Training program costs
b. Inspection and testing program costs by others.
c. Fire protection engineering.
Section 26
The cost of an inspection and testing program by others is intended to identify work
provided by other departments, such as a maintenance section or outside contractor. Do
not include costs of mobile apparatus or other major equipment purchases. Provide
additional explanation for significant deviations in recurring costs between calendar years.
7. PERFORMANCE EVALUATION.
a. Reporting elements should identify the most recent date, performance issues
assessed, and outcome reached by the DOE Federal field element or DOE
authority having jurisdiction on fire protection program performance.
b. Federal field elements: Provide and maintain an evaluation process for contractor
performance. Suggested guidance is provided in Table F-2.
DOE M 231.1-1A Appendix F
3-19-04 F-7
Table F-2. Program Performance Measures.
Code Performance Measure
P0 FIRE PROTECTION ENGINEERING
P1 Site fire protection program documents are comprehensive (as compared to the DOE Fire
Protection Handbook) and updated every 3 years.
P2 Fire hazards analyses/fire protection program assessment reports are complete (as
compared to the examples in the DOE Fire Protection Handbook) and current. (Refer to the
DOE G 440.1-5, Implementation Guide for Use with DOE O 420.1 and DOE O 440.1, Fire
Safety Program, dated 9-30-95.
P3 Inventories of fire protection and emergency services audit findings (new, closed, open,
delinquent) are decreasing.
P4 Qualifications and training of site fire protection engineering staff meet or exceed the site (or
organizational) workload analysis (or equivalent).
P0 FIRE PROTECTION SYSTEM
P5 Fire protection systems (including fire barriers) are inspected, tested and maintained in
accordance with the established site program.
P6 Fire alarm activation statistics (number of alarm and cause) are current and accurate.
P7 Fire protection system failure rates (refer to the DOE Fire Protection Handbook for operability
requirements) have not exceeded the site historic norm by more than 10 percent.
P8 Maintenance costs for each type of fire protection system have not exceeded the site historic
norm by more than 10 percent.
P9 Fire protection system maintenance technicians meet or exceed local industry qualifications
and training requirements.
P0 EMERGENCY SERVICES
P10 The site has access to a fleet of mobile apparatus capable of responding effectively and in a
timely manner to all credible, anticipated site emergencies as determined by a Baseline
Needs Assessment (BNA). Additionally, such assessments address the requirements of
NFPA 1710 with any equivalencies documented and approved by the Local DOE Authority
Having Jurisdiction.
P11 The emergency services organization satisfies staffing and response levels as defined by the
BNA.
P12 Emergency services personnel meet or exceed required minimum qualifications and training
as defined by the BNA
P13 Fire department/brigade pre-plans and program documents are complete and current.
P14 Emergency services equipment has been provided as per the BNA and is maintained in
accordance with industry standards.
P15 Emergency communications capability is functional throughout the site and meets or exceeds
industry standards.
P16 Fire department brigade operational statistics (e.g., number and type of emergency and non-
emergency responses, training hours, number of emergency drills) are accurate and current.
Appendix F DOE M 231.1-1A
F-8 3-19-04
8. CRITERIA FOR COST ESTIMATING.
Section 27
a. Estimating fire damage costs for DOE facilities and programs is essential to
categorize necessary investigations and quantify financial loss to the
Government for either direct reimbursement or analytical purposes. When
estimating loss, it is expected that reporting elements make every attempt to
calculate a credible replacement value and to grade such estimate on the
financial impact it will have upon the Government. For example, a room-and-
contents fire involving standard office products may not require the use of a
detailed cost estimation and may be calculated according to the institutional
knowledge of the reporting authority. However, a total facility loss or losses
exceeding $10,000 in replacement value may need to employ estimation
techniques described in paragraph 9a below.
b. There are qualified people in DOE and/or contractor organizations who are
trained and experienced in cost estimating. These individuals should follow the
procedures in DOE G 430.1-1. When estimating costs from fire loss events,
these individuals should be involved to identify replacement values using
available site data sources such as the Management Analysis Reporting System,
the Property Information Database System, and the Facility Information
Management System and may include applying an appropriate cost index ratio
(e.g., the producer price index) or data published in the periodical, Engineering
News Record.
c. Text in paragraph 9 below provides guidance for determining loses based on the
value of property that is destroyed or otherwise impaired by a fire.
9. CRITERIA FOR LOSS ESTIMATION.
a. Loss estimation includes the following.
(1) Damage or loss of facilities, inventories, and associated equipment as a
result of a fire or a fire suppression system actuation.
(2) All estimated or actual costs to restore DOE property to a reasonable
approximation of pre-accident conditions. If an accident involves
property that has been lost, completely destroyed, or contaminated to a
degree precluding economically justifiable recovery, estimates shall be
based on cost for actual replacement and installation of comparable
equipment, devices, or materials (including nuclear materials) as well as
clean-up and disposal cost for the damaged facility. Such costs should
include credit for any salvage value associated with the loss.
(3) In the case of unused, obsolete, or excess building space, equipment, or
materials that are not going to be replaced, the cost estimate of the
market value at time of accident shall be used.
DOE M 231.1-1A Appendix F
3-19-04 F-9
(4) Estimated costs for restoring to a reasonable degree to pre-accident
condition, without improvement, all partially lost or damaged DOE
property. Include replacement cost for all DOE-owned supplies and
costs for decontamination operations where applicable.
(5) Estimated costs for reprocessing and reclaiming partially destroyed and
damaged materials. Where applicable, costs for damage resulting from
firefighting (e.g., water and smoke damage) should be included.
(6) All post-incident cleanup expenses both inside and outside the facility
(e.g., cleanup of hazardous materials or radioactive contamination
resulting from fires, or fire suppression system actuation).
(7) All costs for recharging fire suppression systems (gaseous, chemical and
foam agents) and decontamination or replacement of fire department
equipment.
(8) Costs for damage caused by DOE operations to privately owned property.
Section 28
(9) Costs for restoration of land and land improvements (sidewalks, roads,
etc.) that were damaged as a result of an accident.
(10) Costs for outside specialists or organizations hired to mitigate losses and
costs for non-standard labor hours (i.e., above the amount normally
worked by the employee) for onsite personnel to restore the property to
pre accident condition
(11) Any lost revenue experienced as a result of the accident. Examples
include income-producing processes, such as power generating and
transmission facilities or timber sales, whose loss would cause a reduction
in payments to the Federal Government.
(12) Estimated damage losses to Government or private wetlands, grasslands,
and forest as a result of a wild land fire originating on DOE lands.
Restoration costs should also be included along with actual costs to
suppress the event.
(13) Labor hours expended by investigative and/or administrative personnel as
a result of the incident.
(14) Labor cost for personnel evacuated during a fire including any stand-down
costs associated with: investigations, employee relocations, or restoration
activities.
Appendix F DOE M 231.1-1A
F-10 3-19-04
b. Loss estimation excludes the following.
(1) Expenses resulting solely from loss of the use or occupancy of facilities
affected by the fire, including lost production and research time, unless it
becomes necessary to obtain special facilities (e.g., temporary structures)
to maintain the facilities' use or occupancy.
(2) All post-accident expenses paid by non-DOE sources (e.g., expenses
covered by private insurance).
(3) Expenses to bring property to modern standards.
(4) Normal wear.
(5) Damage to privately owned property caused by other than DOE
operations.
(6) Labor hours for onsite firefighters during their normal work shifts.
DOE M 21.1-1A Appendix G
6-12-07 G-1
Vertical line denotes change.
APPENDIX G. INSTRUCTIONS FOR PREPARING OCCUPATIONAL EXPOSURE
DATA FOR SUBMITTAL TO THE RADIATION EXPOSURE MONITORING SYSTEM
(REMS) REPOSITORY
1. TRANSMITTAL LETTER.
A transmittal letter containing the following information at a minimum will
accompany each submittal to the REMS repository.
Data filename.
Operating system used to create the data file.
Contact name and phone number of individual knowledgeable about the
submittal.
The number of records included in the submittal.
The collective total effective dose equivalent (TEDE) for individuals included
in the submittal.
Other instructions that may be useful in processing the submittal.
Signature and date of the organization’s authorized representative.
Description of the activities conducted at the facility during the monitoring year
as it relates to the collective radiation exposure received. The text should
include, at a minimum, a general explanation of increases or decreases in the
annual collective TEDE, DDE, and CEDE, a description of events concerning
any TEDE in excess of 2 rems (20 mSv) including references to any
Occurrence Reports related to the exposure, and any other unusual events or
operational changes related to occupational exposure at the facilities included
in the submittal.
The exposure data file is to be error checked using the latest version of the REMSView
program provided by the REMS repository and all reported errors resolved prior to
transmitting the file to REMS. REMSView may be obtained from the DOE REMS
Project Manager, or online at http://www.hss.energy.gov/csa/csp/rems/.
Section 29
2. MEDIA REQUIREMENTS.
Data will be submitted to REMS via electronic media. The default electronic media
for exposure data is an IBM compatible 3.5-inch diskette, 1.44 MB formatted capacity.
Other magnetic media are acceptable, but must be approved by the DOE REMS
Project Manager prior to submission. The data file may be compressed on the
electronic media as long as instructions and required software needed to extract the
data file are provided. Alternative methods of electronic submission may be
accommodated if approved in advance by the DOE REMS Project Manager.
Appendix G DOE M 231.1-1A
G-2 3-19-04
a. File Structure.
Each data record is to be of a fixed length. Extra spaces in the field should be
padded with blanks. Do not use nulls (ASCII character 0), or tabs, or any other
non-printable characters in any record. Terminate each record with a carriage
return and line feed. Responses are required to all fields unless otherwise
noted.
3. INSTRUCTIONS FOR PREPARING ELECTRONIC OCCUPATIONAL
EXPOSURE DATA SUBMITTALS. Individual exposure data records required to be
reported to the Radiation Records Repository will be formatted as shown in Table G-1.
Table G-1. Electronic Data Submittals.
# Data Element
Example
Code or Data
Field
Size
Column
Range Instructions
1 Monitoring Year 2003 4 1–4 Enter the year for which the monitoring
results are being submitted. The
monitoring year, as defined in 10 CFR
835.2 may differ slightly from the
calendar year due to dosimetry
processing schedules.
2 Organization
Code
1234567 7 5–11 7-digit organization code, available
from the repository. Whenever
possible, the appropriate CAIRS
organization code should be used.
See Appendix E (2).
3 Facility Code LAB #12 15 12–26 The code representing the facility
where the dose was received for the
personnel exposure records.
Organizations may determine the
Facility Code using printable ASCII
characters of 15 characters or less.
The Facility Code assigned should
remain consistent from year to year.
4 Facility Type
Code
61 2 27–28 See Facility Type codes, Table G-4
5 Phase of
Operation
C 1 29 See Phase of Operation codes, Table
G-5
6 ID Number 123456789 15 30–44 The identification number for this
individual.
7 ID Type SSN 3 45–47 The type of identification number used
to identify the individual. See ID Type
codes Table G-6.
8 First Name Mary 30 48–77 Legal first name or initial
9 Middle Name Q 20 78–97 Middle name or initial
10 Last Name Public 30 98–127 Last name including title
DOE M 21.1-1A Appendix G
3-19-04 G-3
Table G-1. Electronic Data Submittals (continued).
# Data Element
Example
Code or Data
Field
Size
Column
Range Instructions
11 Birth Date 19660101 8 128–135 Date of birth of individual
(YYYYMMDD)
12 Sex F 1 136 Sex of the monitored individuals
13 Occupation Code 184 3 137–139 See Occupation Codes, Tables G-7
14 Monitoring Status E 1 140 E General Employee, employee of
the reporting organization,
visiting researcher, or student
P Member of the Public, including
visiting dignitaries
G Special Individuals as defined in
Chapter III, paragraph 1b(1)
15 Exposure Type R 1 141 R Routine
P PSE, Planned Special
Exposure
E Emergency, exposure that
occurred during an emergency
when emergency dose limits
and procedures were in effect
16 Monitoring Start
Date
20030101 8 142–149 Date monitoring began for the
reporting year (YYYYMMDD)
17 Monitoring End
Date
20031231 8 150–157 Date monitoring ended for the
reporting year (YYYYMMDD)
Section 30
18 Deep Dose
Equivalent (DDE)
120 7 158–164 The effective dose equivalent to the
whole body, nominally at 1.0 cm depth
from external radiation sources,
including neutron radiation in millirem.
DDE monitoring should be conducted
in accordance with the guidance
provided in DOE G 441.1-4, External
Dosimetry Program Guide for Use with
Title 10, CFR, Part 835, Occupational
Radiation Protection, dated 3-17-99. If
monitoring is not provided, the field
should be blank (padded with spaces).
Enter NM as associated measurement
code.
19 DDE
Measurement
Code
MV 2 165–166 Measurement code for the DDE value.
See Measurement Codes, Table G-8.
20 Deep Dose
Equivalent from
Neutron (DDE-
neutron)
20 7 167–173 The effective dose equivalent to the
whole body, nominally at 1.0 cm depth
from neutron radiation in millirem.
DDE-neutron monitoring should be
conducted in accordance with the
guidance provided in DOE G 441.1-4.
If monitoring is not provided, the field
should be blank (padded with spaces)
and ‘NM’ should be entered as the
associated measurement code.
Appendix G DOE M 231.1-1A
G-4 3-19-04
# Data Element
Example
Code or Data
Field
Size
Column
Range Instructions
21 DDE Neutron
Measurement
Code
MV 2 174–175 Measurement code for the DDE
neutron value. See Measurement
Codes, Table G-8.
22 Dose to the Lens
of the Eye (LDE)
(blank,
padded with
spaces)
7 176–182 Dose equivalent to the lens of the eye
at a tissue depth of 0.3 cm in millirem,
including the deep dose from neutron
radiation in millirem. LDE monitoring
should be conducted in accordance
with the guidance provided in DOE G
441.1-4. If monitoring is not provided,
the field should be blank (padded with
spaces) and ‘NM’ should be entered as
the associated measurement code.
23 LDE
Measurement
Code
NM 2 183–184 Measurement code for the LDE value.
See Measurement Codes, Table G-8.
24 Shallow Dose
Equivalent to the
skin of the Whole
Body (SDE-WB)
120 7 185–191 Dose equivalent from external
radiation at a depth of 0.007 cm to the
skin of the whole body, including the
deep dose from neutron radiation in
millirem. SDE-WB monitoring should
be conducted in accordance with the
guidance provided in DOE G 441.1-4.
If monitoring is not provided, the field
should be blank (padded with spaces)
and ‘NM’ should be entered as the
associated measurement code.
25 SDE-WB
Measurement
Code
MV 2 192–193 Measurement code for the SDE-WB
value. See Measurement Codes,
Table G-8.
26 Shallow Dose
Equivalent,
Upper Right
Extremity (SDE-
UR)
120 7 194–200 Dose equivalent from external
radiation at a depth of 0.007 cm to the
upper right extremity (e.g., right hand),
including the deep dose from neutron
radiation in millirem. If monitoring is
not provided, the field should be blank
(padded with spaces) and ‘NM’ should
be entered as the associated
measurement code.
27 SDE-UR
Measurement
Code
MV 2 201–202 Measurement code for the SDE-UR
value. See Measurement Codes,
Table G-8.
28 Shallow Dose
Equivalent,
Upper Left
Extremity (SDE-
UL)
150 7 203–209 Dose equivalent from external
radiation at a depth of 0.007 cm to the
upper left extremity (e.g., left hand),
including the deep dose from neutron
radiation in millirem. If monitoring is
not provided, the field should be blank
(padded with spaces) and ‘NM’ should
be entered as the associated
measurement code.
DOE M 21.1-1A Chg 2 Appendix G
6-12-07 G-5
Vertical line denotes change
Table G-1. Electronic Data Submittals (continued).
# Data Element
Example
Code or Data
Field
Size
Section 31
Column
Range Instructions
29 SDE-UL
Measurement
Code
MV 2 210–211 Measurement code for the SDE-UL
value. See Measurement Codes, Table
G-8.
30 Shallow Dose
Equivalent,
Lower Right
Extremity (SDE-
LR)
(blank,
padded with
spaces)
7 212–218 Dose equivalent from external radiation at
a depth of 0.007 cm to the lower right
extremity (i.e., right foot, ankle, or lower
leg), including the deep dose from
neutron radiation in millirem. If
monitoring is not provided, the field
should be blank (padded with spaces)
and ‘NM’ should be entered as the
associated measurement code.
31 SDE-LR
Measurement
Code
NM 2 219–220 Measurement code for the SDE-LR
value. See Measurement Codes, Table
G-8.
32 Shallow Dose
Equivalent,
Lower Left
Extremity (SDE-
LL)
(blank,
padded with
spaces)
7 221–227 Dose equivalent from external radiation at
a depth of 0.007 cm to the lower left
extremity (i.e., left foot, ankle, or lower
leg), including the deep dose from
neutron radiation in millirem. If
monitoring is not provided, the field
should be blank (padded with spaces)
and ‘NM’ should be entered as the
associated measurement code.
33 SDE-LL
Measurement
Code
NM 2 228–229 Measurement code for the SDE-LL value.
See Measurement Codes,
Table G-8.
34 Committed
Effective Dose
Equivalent
(CEDE)
30 7 230–236 The 50-year CEDE from intakes during
the monitoring period in millirem.
35 CEDE
Measurement
Code
MV 2 237–238 Measurement code for the CEDE value.
See Measurement Codes, Table G-8
36 Radionuclide 1 U238 7 239–245 The scientific abbreviation of the
radionuclide taken into the body that
contributed to the internal dose. Use the
standard scientific format of “Xx999x”,
where “X” represents an alphanumeric
and “9" represents a numeric character.
List only the six highest contributors
among the following fields. Enter only one
radionuclide per field. Do not include
daughter products. When possible, list
the radionuclides in descending order of
their contribution to the internal dose.
Appendix G DOE M 231.1-1A Chg 2
G-6 6-12-07
Vertical line denotes change.
Table G-1. Electronic Data Submittals (Continued)
#
Data
Element
Example
Code or
Data Field Size
Column
Range Instructions
37 Radionuclide
2
U239 7 246–252 The scientific abbreviation of the
second radionuclide taken into the
body.
38 Radionuclide
3
Pu239 7 253–259 The scientific abbreviation of the third
radionuclide taken into the body.
39 Radionuclide
4
(blank
padded
with
spaces)
7 260–266 The scientific abbreviation of the fourth
radionuclide taken into the body.
40 Radionuclide
5
(blank
padded
with
spaces)
7 267–273 The scientific abbreviation of the fifth
radionuclide taken into the body.
41 Radionuclide
6
(blank
padded
with
spaces)
7 274–280 The scientific abbreviation of the sixth
radionuclide taken into the body.
42 Committed
Dose
Equivalent
(CDE) to the
gonads
(blank,
padded
with
spaces)
7 281–287 The 50-year Committed Dose
Equivalent to the gonads from the
intake of the radionuclides for this
monitoring period, in millirem.
43 Committed
Dose
Equivalent
(CDE) to the
breasts
(blank,
padded
with
spaces)
7 288–294 The 50-year Committed Dose
Equivalent to the breasts from the
intake of the radionuclides for this
monitoring period, in millirem.
44 Committed
Dose
Equivalent
(CDE) to the
red bone
marrow
35 7 295–301 The 50-year Committed Dose
Equivalent to the red bone marrow
from the intake of the radionuclides for
this monitoring period, in millirem.
Section 32
45 Committed
Dose
Equivalent
(CDE) to the
lungs
25 7 302–308 The 50-year Committed Dose
Equivalent to the lungs from the intake
of the radionuclides for this monitoring
period, in millirem.
46 Committed
Dose
Equivalent
(CDE) to the
thyroid
(blank,
padded
with
spaces)
7 309–315 The 50-year Committed Dose
Equivalent to the thyroid from the
intake of the radionuclides for this
monitoring period, in millirem.
DOE M 21.1-1A Chg 2 Appendix G
6-12-07 G-7
Vertical line denotes change.
Table G-1. Electronic Data Submittals (Continued)
#
Data
Element
Example
Code or
Data Field Size
Column
Range Instructions
47 Committed
Dose
Equivalent
(CDE) to the
bone surface
500 7 316–322 The 50-year Committed Dose
Equivalent to the bone surface from
the intake of the radionuclides for this
monitoring period, in millirem.
48 Committed
Dose
Equivalent
(CDE) to the
remainder
40 7 323–329 The 50-year Committed Dose
Equivalent to the remainder from the
intake of the radionuclides for this
monitoring period, in millirem.
49 Total
Effective
Dose
Equivalent,
(TEDE)
150 7 330–336 The sum of the Deep Dose Equivalent
(DDE) and the Committed Effective
Dose Equivalent (CEDE) in millirem.
50 Dose
Equivalent to
the
Embryo/Fetus
10 7 337–343 Dose Equivalent to the embryo/ fetus
during the pregnancy from conception
to the end of the pregnancy, in
millirem. Dose determination should
be made in accordance with DOE G
441.1-6, Evaluation and Control of
Radiation Dose to the Embryo/Fetus
Guide for Use with Title 10, Code of
Federal Regulations, Part 835,
Occupational Radiation Protection,
dated 4-29-99.
51 Comment
Text
Further
information
for this
dose
record is
contained
in the
Occurrence
Report #
140 344–483 Text of the comment applicable to the
dose record in the data file.
Comments should be limited to
information needed to assess the
record, such as references to
additional documentation concerning
the record. If no comments are
necessary, the record may be
terminated with a carriage return and
line feed at column 346 with one
space entered for the comment.
4. OCCUPATIONAL EXPOSURE DATA SUMMARY EXPLANATION.
Policies and procedures should be in place to ensure that duplicate monitoring results for
an individual are not reported to the repository by more than one organization.
All dose equivalents will be in units of millirem, rounded to the nearest whole number
and right justified within the appropriate field. If monitoring was not provided for a
Appendix G DOE M 231.1-1A Chg 2
G-8 3-19-04
specific dose value, do not enter a value. Leave the field blank, padded with spaces, and
enter NM in the corresponding measurement code field.
Occupational exposure monitoring should be provided in accordance with the guidance
provided in the following DOE documents: DOE G 441.1-3A, Internal Dosimetry
Program Guide for Use with Title 10, Code of Federal Regulations, Part 835,
Occupational Radiation Program, dated6-11-2005 and DOE G 441.1-4A External
Dosimetry Program Guide for Use with Title 10, Code of Federal Regulations, Part 835,
Occupational Radiation Protection, dated 6-1-2005.
Dose records for more than one facility are required only where radiation monitoring is
performed and recorded for specific facilities. If only site-wide monitoring is provided,
only one facility record code should be included in the submittal to represent the entire
site. For individuals receiving dose at multiple facilities where the fraction of dose
received at each facility code cannot be determined, the entire dose should be attributed
to the facility where the majority of dose was received. If the facility where the majority
of dose was received cannot be determined, the facility code where the individual spent
the majority of the monitoring period should be used.
Section 33
Comment records are required only if additional information is needed to assess the
record.
Reporting of fetal exposure data is required for a declared pregnant worker. Fetal
exposure data should be included in the submittal for the monitoring year that
encompasses the pregnancy end date.
5. BIOASSAY AND INTAKE SUMMARY FILE EXPLANATION.
The following files must be submitted as separate ASCII files containing annual summary
records for bioassay and intake information. These files should be submitted on the same
media as the annual submittal as shown in Tables G-2 and G-3 respectively. The Bioassay
Summary file should contain one record for each facility. The Intake Summary file should
contain one record for each facility, radionuclide, and intake mode.
Bioassay Summary records are required to be reported when any individual participates in
a bioassay program or in vivo monitoring during the monitoring year.
DOE M 21.1-1A Appendix G
3-19-04 G-9
Intake Summary records are required to be reported when any individual has received a
dose from intakes during the monitoring year.
Table G-2. Bioassay Summary File.
#
Data
Element
Example
Code or Data
Field
Size
Column
Range Instructions
1 Facility
Code
LAB #12 15 1–15 The code representing the facility where the
dose was received for the personnel exposure
records. Organizations may determine the
Facility Code using printable ASCII characters of
15 characters or less. The Facility Code
assigned should remain consistent from year to
year.
2 Monitoring
Year
2003 4 16–19 Enter the year for which the monitoring records
are being submitted. The monitoring year, as
defined in 10 CFR 835.2 may differ slightly from
the calendar year due to dosimetry processing
schedules.
3 Total 237 5 20–24 Total number of individuals monitored in the
bioassay program or in vivo monitoring during
the year.
4 Routine 233 5 25–29 Number of routine bioassay performed during
the year.
5 Special 4 5 30–34 Number of special bioassay or in vivo
measurements performed during the year.
6 Urinalysis 212 5 35–39 Number of urine samples analyzed during the
year.
7 Fecal 32 5 40–44 Number of fecal samples analyzed during the
year.
8 In Vivo 120 5 45–49 Number of in vivo measurements performed
excluding wound counts during the year.
9 Wound 3 5 50–54 Number of in vivo measurements performed on
wounds during the year.
10 Other 1 5 55–59 Number of other measurements performed in
order to determine internal dose for an individual
during the year (e.g., air sampling or other
method).
1 Facility
Code
LAB# 12 15 1–15 The code representing the facility where the dose
was received for the personnel exposure records.
Organizations may determine the Facility Code using
printable ASCII characters of 15 characters or less.
The Facility Code assigned should remain consistent
from year to year.
Appendix G DOE M 231.1-1A
G-10 3-19-04
Table G-3. Intake Summary File
#
Data Element
Example
Code or Data
Field
Size
Column
Range Instructions
2 Monitoring Year 2003 4 16–19 Enter the year for which the monitoring
results are being submitted. The
Monitoring Year as defined in 10 CFR
835.2 may differ slightly from the
calendar year due to dosimetry
processing schedules.
3 Radionuclide Pu238 7 20–26 The scientific abbreviation of the
radionuclide taken into the body. Use
the standard scientific format of
“Xx999x”, where “X” represents an
alphanumeric and “9" represents a
numeric character. Enter only one
radionuclide per record. Do not include
daughter products or radionuclides that
did not result in internal doses during
the monitoring year.
Section 34
4 Mode W 1 27 Mode of the intake.
H = Inhalation (record tritiated water
intakes as inhalations.)
G = Ingestion
A = Absorption
W = Wound, cut, puncture, injection or
any other intake through broken skin.
A separate record for each mode and
radionuclide should be reported.
5 Collective
CEDE
3489 715 28–34 The collective 50-years CEDE from
intakes of this radionuclide and intake
mode during the monitoring year, in
millirem.
6. FACILITY TYPE CODES.
The facility record should identify the facility type where the worker’s doses were
received. The facility type should reflect the original function of the facility even if
activities in support of that function are no longer being conducted at the facility. Facility
type codes are listed in Table G-4.
Tables G-4 through G-8 list codes used in filling out occupational exposure records.
Table G-4. Facility Type Codes.
Facility Type
Code Facility Type Description
10 Accelerator
21 Fuel/Uranium Enrichment
22 Fuel Fabrication
DOE M 21.1-1A Appendix G
3-19-04 G-11
Facility Type
Code Facility Type Description
23 Fuel Processing
40 Maintenance and Support (site-wide)
50 Reactor
61 Research, General
62 Research, Fusion
70 Waste Processing/Management
80 Weapons Fabrication and Testing
99 Other
7. FACILITY PHASE OF OPERATION CODES.
The phase of operation will be recorded for the calendar year for which the phase of
operation is most appropriate. For facilities that transition between phases during a year,
the phase that is appropriate for the majority of the calendar year should be recorded.
Each DOE facility falls into one of the Phase of Operations shown in Table G-5. In
general, each phase follows in sequential order, although a facility may forgo one or more
phases or may not follow the order listed here.
Appendix G DOE M 231.1-1A
G-12 3-19-04
Table G-5. Facility Phase of Operation Codes.
Code Phase of Operation Definition
A Construction (includes
Major Renovation)
New facilities that are brought on line to replace or augment
existing facilities. This phase includes major renovations for
existing facilities but does not include environmental
restoration construction.
B Operations/Maintenance Includes the normal, mission-related operations and
maintenance of the reported Facility Type.
C Stabilization Facilities that have been declared to be surplus (assigned to
the environmental restoration program). This includes
facilities where all operations have been suspended but
environmental restoration activities have not begun. This
may include periods of surveillance and maintenance prior to
environmental restoration activities.
D Remediation Period during which corrective actions that are necessary to
bring the facility into regulatory compliance are being
performed.
E Decontamination and
Decommissioning
Decontamination is the act of removing a chemical,
biological, or radiological contaminant from, or neutralizing its
potential effect on, a person, object, or environment by
washing, chemical action, mechanical cleaning, or other
techniques. Decommissioning is the process of closing and
securing a facility.
F Waste Management This phase includes the management of wastes generated
during the environmental restoration process.
G Surveillance and
Maintenance
This phase includes those activities that provide for the
safety and protection of a facility after the environmental
restoration phase.
Z Other All DOE facilities should fit into one of the above categories.
“Other” should be used only in highly unusual circumstance.
Section 35
Table G-6. Identification Codes.
ID Type Code Identification Type Description
SSN U.S. Social Security Number
PPN Passport Number
CSI Canadian Social Insurance Number
WPN Work Permit Number
OTH Other1
1
Other identification numbers are unique identifiers assigned by the reporting organization when all other
identification types are unavailable. The individual’s SSN should be used whenever possible. The first 7 digits
of an “other” identification number must be the organization code for the reporting organization. The remaining
8 digits of the ID number should be unique for each individual being submitted by the reporting organization.
DOE M 21.1-1A Chg 2 Appendix G
6-12-07 G-13
Vertical line denotes change.
Table G-7. Occupational Codes.
DOE Code DOE Occupational Categories
Cross-Reference
SOC Code (ranges)1
1 UNKNOWN
110 MANAGERS AND ADMINISTRATORS 11–14
PROFESSIONAL 15–39
160 Engineers 16
170 Scientists 17–19
184 Health Physicists 1843
200 Miscellaneous Professionals 20-25, 32–34
260 Doctors and Nurses 26–30
350 Technicians 35–39
360 Health Technicians 36
370 Engineering Technicians 37
380 Science Technicians 38
383 Radiation Monitors/Technicians 383
390 Miscellaneous Technicians 39
400 SALES 40–44
450 ADMINISTRATIVE SUPPORT AND CLERICAL 45–47
SERVICE WORKERS 50–52
512 Firefighters 512
513 Protective Force 513/4
521 Food Service Employees 521
524 Janitors 524
525 Miscellaneous Service Employees 523, 525/6
AGRICULTURAL WORKERS 55–58
562 Grounds keeper 562
570 Forest Workers 57
580 Miscellaneous Agricultural Workers 55, 561, 58
REPAIR/CONSTRUCTION WORKERS 60–65
610 Mechanics/Repairers 60–61
641 Masons 641
642 Carpenters 642
643 Electricians 643
644 Painters 644
Appendix G DOE M 231.1-1A Chg 2
G-14 6-12-07
Vertical line denotes change.
DOE Code DOE Occupational Categories
Cross-Reference
SOC Code (ranges)1
645 Pipe Fitters 645
650 Miners/Drillers 65
660 Miscellaneous Repairers/Construction Workers 63, 646
PRECISION/PRODUCTION WORKERS 67–78
681 Machinists 681
682 Sheet Metal Workers 682
690 Operators, Plant/System/Utility 69
710 Machine Setup/Operators 71–76
771 Welders and Solderers 771
780 Miscellaneous Precision/Production Workers 67, 683–688, 722–78
TRANSPORT WORKERS 81–83
820 Truck Drivers 8212–8214
821 Bus Drivers 8215
825 Pilots 825
830 Equipment Operators 83
840 Miscellaneous Transporters 81, 8216–824, 828
850 HANDLERS/LABORERS/HELPERS 85–87
910 MILITARY PERSONNEL 91
990 MISCELLANEOUS WORKERS 99
1
Refers to the Department of Commerce’s Standard Occupational Classification (SOC) Manual (1980).
DOE M 21.1-1A Appendix G
3-19-04 G-15
Table G-8. Dose Measurement Codes.
Code Meaning Definition
MV Measured
Value
Indicates that measurements were performed for the specific individual to determine
the dose for that individual. This measurement code would apply in all cases where
individual external dosimetry was used or where the individual participated in a
bioassay program (including whole body or lung count) that was used to determine the
individual's internal dose.
PV Preliminary
Value
Indicates that this measurement is an interim estimation and expects to be updated in
a subsequent revision and submittal of this dose record. This measurement code
should be used when the final dosimetry or bioassay results are not yet available but
the submittal is due.
CV Calculated
Value
Section 36
Indicates the value given was calculated from indirect measurements such as
monitoring performed on other workers or determined from a time-motion study or
other analysis such as air sample for internal exposures. The value given represents
the final results of the calculation, but the value was not measured directly for the
monitored individual. A comment record may be provided to explain the reason and
method of calculation.
NM Not Monitored Dosimetry was not provided and was not required to be provided.
ND Not
Detectable
Monitoring was performed but the results were below the detection limit of the
measurement instrumentation.
AVAILABLE ONLINE AT: INITIATED BY:
http://www.directives.doe.gov Office of Environment, Safety and Health
U.S. Department of Energy PAGE CHANGE
Washington, D.C.
Approved: 3-19-04
Chg 1: 9-9-04
SUBJECT: ENVIRONMENT, SAFETY AND HEALTH REPORTING MANUAL
1. PURPOSE. To transmit revised pages to DOE M 231.1A, Environment, Safety and
Health Reporting Manual, dated 3-19-04.
2. EXPLANATION OF CHANGES. To clarify responsibilities pertaining to occupational
injury and illness recordkeeping and recording.
3. FILING INSTRUCTIONS.
Remove Dated Insert Dated
Cover 3-19-04 Cover Chg 1: 9-9-04
Page iii 3-19-04 Page iii 9-9-04
Page II-1 3-19-04 Pages II-1 and II-1a 9-9-04
Pages II-2 through II-5 3-19-04 Pages II-2 through II-5 9-9-04
Page III-1(and III-2) 3-19-04 Page III-1(and III-2) 9-9-04
Attachment 2, Page 3 3-19-04 Attachment 2, Pages 3 and 3a 9-9-04
Attachment 2,
Pages 4 3-19-04
Attachment 2,
Pages 4 and 4a 9-9-04
Attachment 2, Page 5 3-19-04 Attachment 2, Page 5 9-9-04
Appendix C,
Pages C-1 through C-6 3-19-04
Appendix C,
Pages C-1 through C-6 9-9-04
Appendix D, Page D-1 3-19-04 Appendix D, Page D-1 9-9-04
After filing the attached pages, this transmittal may be discarded.
BY ORDER OF THE SECRETARY OF ENERGY:
KYLE E. McSLARROW
Deputy Secretary
DOE M 231.1-1A Chg 1
AVAILABLE ONLINE AT: INITIATED BY:
www.directives.doe.gov Office of Environment, Safety and Health
U.S. Department of Energy PAGE CHANGE
Washington, D.C.
Approved: 3-19-04
Chg 1: 9-9-04
Chg 2: 6-12-07
SUBJECT: ENVIRONMENT, SAFETY AND HEALTH REPORTING MANUAL
1. PURPOSE. To transmit revised pages to DOE M 231.1-1A, Environment, Safety and
Health Reporting Manual, dated 3-19-04.
2. EXPLANATION OF CHANGES. To include responsibilities for investigating and
reporting occupational injuries and illnesses to previously excluded subcontractor
employees.
3. LOCATIONS OF CHANGES.
Pages Paragraphs
i 3, 4a, 4b(1)-(3)
ii 3c(1), 5b, 5c(1)-(4)
vi Title
I-1 1a(1)(a)
II-1 1, 1a
II-2 1a(6)
II-3 1e, 1f, 1f(1)
II-4 1f(1)-(2), 1f(3)(b),
1f(3)(d)
II-5 1f(4), 1f(6)
II-7 6
III-1 1b(3)
Attachment 1
Page 1 1, 1a
Page 2 2b
Page 3 3, 3a, 3b, 3b(2)-(3)
Pages Paragraphs
Attachment 1 (continued)
Page 4 3c, 3d, 3e, 3e(1)
Page 5 3e(2)(a)-(m), 3f
Page 6 3g, 3h. 3i,
3i(2)(b)
Appendix C
C-1 through C6 Table C-1
Appendix E
E-1 1a, 2
E-2 2
Appendix F
F-3 3a(2)-(3)
Appendix G
G-5 through G-7 Table G-1
G-8 4
G-13 through G-14 Table G-7
After filing the attached pages, this transmittal may be discarded.
BY ORDER OF THE SECRETARY OF ENERGY:
CLAY SELL
Deputy Secretary
DOE M 231.1-1A Chg 2