The diagnostic reference levels (DRLs) of the general X-ray radiography are defined by the absorbed dose of air at the entrance surface with backscattered radiation from a scattering medium. Generally, the entrance surface dose of the general X-ray radiography is calculated from measured air kerma of primary X-ray multiplied by a backscatter factor (BSF). However, the BSF data employed at present used water for scattering medium, and was calculated based on the water-absorbed dose by incident primary photons and backscattered photons from the scattering medium. In the calculation of air dose at the entrance surface defined in DRLs, there are no theoretical consistencies for using BSF based on water dose, and this may be a cause of calculation error. In this paper, we verified the difference in BSF by the difference in the scattering medium and by the difference in the objective dose by means of the Monte Carlo simulation. In this calculation, the scattering medium was set as water and the soft-tissue, and the objective dose was set as air dose, water dose, soft-tissue dose, and skin dose. The difference in BSF calculated by the respective combination was at most about 1.3% and was less than 1% in most cases. In conclusion, even if the entrance surface dose defined by DRLs of general X-ray radiography is calculated using BSF, which set both the scattering medium and the object substance of the absorbed dose as water, a so big error doesn't show.