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Historical development of radiation safety practices in radiology

Article in Radiographics · December 1989

DOI: 10.1148/radiographics.9.6.2685944 · Source: PubMed

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 Historical Development of Radiation Safety
Practices in Radiology
Allen Brodsky, Sc.D.

Department of Radiation Science,

Georgetown University, Washington, D.C and .

Allen B Consultants, Derwood, Maryland

Ronald 1. Kathren, M.Sc.

Department of Radiologic Sciences,

University of Washington, Seattle, Washington, and
Hanford Environmental Health Foundation
Hanford, Washington

introduction protection were elucidated during the first de-

dade after Roentgen’s discovery (3). The story
The discovery of x rays brought with it the of the development of radiation protection
immediate recognition that this previously un- methods and their applications in radiology
known form of energy would be of inestimable can be told in terms of four overlapping chro-
value in medicine. The first public announce- nological periods (Table I).
ment of this discovery included the classic ra-
diograph of Frau Roentgen’s hand (1). Thus, it
is not at all surprising that x rays were utilized
for diagnostic purposes, and possibly for thera- TableI
py (2) within a few weeks of the announce- Era of the ProtectIon Pioneers
ment. Given the nearly ubiquitous fascination (1895-1915)
of the public with x rays and their immediate Marked by the initial recognition of the hazard of radia-
and widespread application to medicine, it tion and the development of the earliest protective
was inevitable that x-ray injuries would soon measures by a small cadre of prescient pioneers.
appear. Along with the injuries, came a recog- Golden Age of Radiology
(1915-1940)
nition of the hazard implicit in the use of x radi- Noteworthy not only as a time of great progress in the
ation and of the need for protective rnea- medical application of x rays and radioactivity, but for
sures. The most important provisions for x-ray the beginnings of established units of measurement
and organized efforts in radiation protection.
Golden Age of RadIation Protection
(1940-1960)
RadloGraphlcs Index terms:
HISTORY OF RADIOLOGY The scientific and technical bases of modern protection
IMAGING TECHNOLOGY were developed and the profession of health physics
#{149}
HIstory
RADIATION PHYSICS
was born.
#{149}
ConventIonal Radiography Modern Era
(1960-1989)
Cumulative Index terms Characterized by great growth and complexity in the
Radiology and radiologists,
history medical applications of x rays, radioactivily, and new
RadIatIons, protective and modalities. Intensified concern and regulation of all
therapeutic agents and
things radiological.
devices
Radiations, injurious effects

Address reprint requests to Allen Brodsky, Sc.D., Allen B Consultants, Inc. 16412 Kipling Road, Derwood, MD. 20855-1927.

Volume 9, Number 6, Monograph November,

#{149} 1989 RadloGraphics
#{149} I 267
Historical development of radiation safety Brodsky and Kathren

Era of the Protection Pioneers any real dispute over the ability of x rays to
(1895-1915) produce acute injury.
In our examination of the recognition of
The months following Roentgen’s historic hazards, a few words need to be said about
announcement of x rays were marked by in- radioactivity, which was discovered by Henri
tense activity in studying the newly discovered Becquerel only a matter of weeks after the an-
phenomenon and applying it to medicine and nouncement of the discovery of x rays. Radio-
various other purposes. The scientific and lay activity did not at first excite the investigative
worlds were captivated by the mysterious rays minds of the time; only about a dozen papers
that could penetrate human flesh and reveal on radioactivity were published in the first year
the inner structures of the body. Despite an oc- after its discovery compared with more than a
casional ominous indication to the contrary, thousand on x nays. By 1902, however, the Cu-
there was virtual unanimity within the medical, nies had purified enough radium to identify it as
scientific and lay communities; all were certain a new element. Its potential was quickly real-
that x rays were totally without adverse effect. ized, and by 1904, radium was a well estab-
After all, what harm could there be from some- lished treatment modality.
thing that could not be seen, felt, tasted, The external hazards of radioactive mateni-
heard, or detected in any way by the senses? als were more readily realized than those of x
In March 1896, Edison (4) reported eye inn- rays. Both Becquerel and Pierre Curie incurred
tation associated with the use of x rays, and abdominal erythernas from carrying small sam-
cautioned against their continuing use. He pIes of radioactive materials in their vest pock-
abandoned his own studies devoted toward ets. The swift realization that radium ernana-
an x-ray energized fluorescent light. Sadly, this tions could be useful for destroying malignant
action was too late to prevent the overexpo- or other unwanted tissue attests to the recog-
sure of his assistant, Clarence M. DaIly, who de- nition of its hazardous potential. Radioactive
veloped acute x-ray dermatitis and died in materials in general, and specifically radium,
1904 as a result of his x-ray exposure. were also thought to be beneficial to health in
By the end of 1896, numerous reports of x- quantities too small to produce therapeutic re-
nay dermatitis and even more serious injury had suIts against cancer. Thus, began a great pub-
been published in the scientific and lay litera- lid infatuation with radium that was to last for
tune. One of these was a report by the Amen- decades. This was marked by radium-bearing
can physicist, Thompson, who reported the de- patent medicines, devices to generate radium
liberate exposure of the little finger of his left or radon waters for daily consumption, and the
hand to the direct beam of an x-ray tube over emanatonia at which radon gas could be
a period of several days (5). His exposure re- breathed for its tonic properties.
suited in pain, swelling, stiffness and blistering, Protection from radioactive substances
causing Thompson to caution against ovenex- was schizoid in that some exposure seemed to
posure “ . or there may be cause for regret
. . be desirable, but too much might represent an
when too late. The therapeutic
“ potential of x undesirable situation. It was the protection of
rays and the emanations from radioactive ma- the radium itself, a most valuable and expen-
tenials were quickly realized; thus, as early as sive commodity, rather than the protection of
1896, x rays were used therapeutically where human beings from the emanations from radi-
tissue destruction was the desired effect. The urn that most often dominated the develop-
prevailing opinion, however, seems to have ment of controls, such as storage safes, in the
been that the dermatitis and burns were not early days. Indeed, pre World War II radium de-
caused by the x-rays themselves; but rather, vices are still occasionally recovered from per-
by other factors including: ultraviolet light, the sonal safes or bank vaults; a most dangerous
flight of minute atoms from the target to the undertaking. In his 1927 book, MacKee (6) mdi-
skin, cathode rays, electrical induction, oxida- cated that improvements in x-ray and radium
tion by ozone or other byproducts of x-ray protection were needed. He stated, “There is
generation, idiosyncrasy, or faulty technique. It really no excuse for injury to a physician by ra-
is a little difficult to understand why there was dium.” His book described necessary safety

I 268 RadioGraphics November,

#{149} 1989 Volume 9, Number 6, Monograph
Brodsky and Kathren Historical development of radiation safetys

measures including caution signs, distance, than the current concepts of time, distance
tongs, special containers for dressings, and and shielding for minimizing exposure. He also
checking for loose sources. decried the technique of testing the “hand-
By 1900, improved apparatus, faster ness” of the tube by placing the hand of the
plates, improved techniques, and recognition operator between the tube and a fluorescent
of the hazards resulted in the elimination of screen (7). Even so there seemed to be a sort
acute dermatological hazards. Albers-Sch#{244}n- of somnolence on the part of many of the ear-
berg, himself a victim of chronic x ray induced ly radiologists with regard to the need for fun-
dermatitis, called for restrictions on exposure ther safety measures. Hand held fluonoscopes
frequency (no more than thrice daily), a dis- were still in use. One early model was provided
tance of 30 cm from the tube to the patient, a with a lead shield for protection of the opera-
leaded tube housing, and additional lead ton’s hand from the excessive exposure which
shielding for the operator. These are no less could lead to acute dermatitis (Figure 1).

The Friedlander Fluoroscope Shield

Figure1A
Hand heldfluoroscope (ca. 1902)
with a lead shield to protect the
hand. From a catalog of the Fried-
lander Company, Chicago. Fried-
lander sold many protective de-
vicesincludeda patentedx-ray
tube shield that cost $ 10- 14, de-
pending on size. Fniedlanden him-
self died of radiation effects.

For protecting the hand that is exposed while using the fluor.
Made of the same material as our X Ray shield, and can be fltte
auoroscoPe by attaching to the box by two small screws.

No. S5. PrIce, $.OO.

FigurelB
The “no hands” approach, appears rather clumsy.
Neither this type of shield nor the one in Figure 1A
protected the body from primary on scattered radia-
tion. (Figures are supplied by Dr. Nancy Knight and
used with permission of the American College of Ra-
diology.)

Volume 9, Number 6, Monograph #{149}November, 1989 RadioGraphics

#{149} I 269
Historical development of radiation safety Brodsky and Kathren

Public and media pressure stimulated the ma dose per year. In modern units this is an an-
development of x-ray protection measures. As nual limit of about two thirds of a gray (65 rad).
early as 1897, the courts awarded a $10,000 The pioneer era of protection ended with
damage judgment on behalf of a plaintiff who the development of means for the quantita-
allegedly suffered necrotic damage from irn- tive measurement of radiation exposure. The
proper application of diagnostic x rays. In roentgen was adopted at the Second Interna-
1899, John Dennis, a newspaper reporter, cru- tional Congress on Radiology in 1928. Toler-
saded for controls, recommending state Ii- ance doses were now expressed in quantita-
censing for radiographers and asserting that tive form. By 1934, M#{252}tschellerrecognized the
injury of a patient was a criminal act. Albers- differing biological effectiveness of different
Sch#{244}nberg put protection against legal action radiations and stated a tolerance dose of 3.4 R
on the same level as protection of the public per month for low energy radiation and 7.5 R
against burns. per month for the more penetrating rays (10).
The premier protection pioneer in the United At the time, the concept of tolerance dose rn-
States was William Rollins, a shy and reserved plied a threshold below which no radiation in-
Boston area dentist (8). He pursued his radio- jury could occur. The concept of tolerance
logic researches over the course of a dozen dose persisted through the era despite the
years, “. as a recreation”.
. . His contributions 1927 demonstration by the Nobel prizewinner
included the “cryptoscope” with a lead glass Herman J. Muller of the likely absence of a
backed fluorescent screen and leaded walls in threshold for radiation induced mutations.
1896; suggestions for protective tube housings In the mid-twenties, there were several nec-
in 1902; lead glass goggles (a full centimeter ommendations for the routine use of film
thick) for fluoroscopists as protection against badges. By the end of the decade, it was
cataracts; pulsed fluoroscopy and selective fil- known that film should be carried in holders
tration in 1903. He made several recommen- equipped with filters to connect for the energy
dations for protection in the use of radioactive dependence of the film. By the thirties, the
materials, and investigated the lethal effects commercially manufactured portable survey
of radiation on the fetus of the guinea pig. meters and the condenser ionization chamber
These contributions appeared in more than (R-rneten) were standard instruments in most
200 notes on ‘The X-Light’ and a privately pub- hospitals (Figure 2).
lished book (9). The United States Advisory Committee on
X-ray and Radium Protection was formed in
1929. The original committee comprised five
The Golden Age of Radiology physicists and three physicians. Because of its
(1915-1940) origins in the work of radiological societies,
much of its attention was directed toward
The development of the Coolidge tube in medical activities. The committee was deliber-
1913 provided the basis for the stable and ne- ately vague, however, about to whom or to
producible operation of equipment, a neces- what body it had formal responsibility. Launis-
sary requirement for evolution of the tech- ton S. Taylor of the National Bureau of Stan-
nique. During, and immediately after World dards was one of the organizers of this group
War I, initial sets of rules for radiation protec- and soon became its chairman. Sixty years lat-
tion were issued by various national radiologi- er he is still an active contributor to the field of
cal societies. These rules also included sections radiation protection. His extensive notes have
on electrical hazards and ventilation. The con- been published and give a detailed descnip-
cepts of limited working hours and extra vaca- tion of the evolution of radiation protection
tion for radiation workers date from that era. concepts and standards (11). The committee’s
(Sadly, radiation protection standards have second report, which appeared in 1934, dealt
advanced to a point at which the authorities with radium protection. In it, were recommen-
can no longer justify the latter necommenda- dations for preemployrnent physicals, six
tion.) The initial recommendations were to limit weeks of vacation, and periodic blood counts.
exposures to about ten percent of an erythe- The permissible level was set at 0. I R/day for

I 270 RadioGraphics November,

#{149} 1989 Volume 9, Number 6, Monograph
Brodsky and Kathren Historical development of radiation safetys

sphere. These limits were chosen by setting the

“safe” level to be lower than that amount of
radium remaining in any of the radium dial
painters who had suffered from bone cancer
after working in factories in which they painted
luminous dials for World War I aircraft (12). The
painting technique had included tipping the
paint brushes by mouth while painting dials
with radium-activated luminous paint. This limit
later served as a basis for establishing body
burden and Intake limits for other nudlides. It
has been found to be a reasonable and safe
standard to the present time.
The impact of the Manhattan District (the
development of the atomic bomb) on radia-
tion protection was enormous and was felt rn-
mediately after the cessation of the war (13).
Advances were made in the instrumentation
needed to detect and measure radiation, in-
Figure 2 dluding improved ion chamber survey meters
An early portable ionization survey meter (ca. 1942) that could accurately monitor the output and
built by the Victoreen Instrument Company, Cleve- stray radiation from diagnostic x-ray appara-
land. The ion chamber is a closed-end mailing tube tus. An enormous amount of radiobiological re-
of cardboard, coated on the inside with acquadag. It search was carried out. A new profession of
was powered by a 45-volt battery, which limited re- “Health Physics” was born, since the great
duction of the size and weight of the instrument. quantities, and extremely varied chanactenis-
(Figure supplied by Arthur Lucas and used with per- tics of the many new radionudlides created by
mission ofthe Victoreen Co.) nuclear fission required the full-time attention
of specially trained professionals. It is worth-
while to quote a few words from Morgan (13):
the whole body and 5 R/day to the fingers. This “At first it was thought that only a few health
concept of organ specific limits was, perhaps, physicists would be needed at Oak Ridge to
a compromise that recognized the impor- serve as advisors and consultants to the van-
tance of not unduly restricting the physician in ous divisions on radiation problems. However,
the performance of his work. several near accidents shortly after the pile
started operating led to a revision of plans. . It
.

was found that scientists and production men

The Golden Age of Protection became so interested in their experiments or
(1940-1960) occupied with various operations that they
could easily overlook this unseen radiation haz-
From a medical standpoint, the start of this and. When man receives too much heat from a
era might well be marked by the publication of thermally hot object he recoils in pain. Howev-
the National Bureau of Standards Handbook en, when he walks in front of an experimental
H27, “Safe Handling of Radioluminous Corn- hole in the pile shield, or when the back side of
pound” in 1941. This document reaffirmed the a shield from around a radioactive source is
previous exposure level of 0. 1 R/day for exter- left off . serious radiation
. . damage may re-
nal exposure of radiation workers. It intro- suIt, not only to the careless individual, but to
duced the concepts of maximum permissible others who work anywhere near him. Then,
body burden of an ingested nadionudlide (0.1 too, he may not be aware of the damage sus-
microcunie of radium) and a maximum perrnis- tamed until several days or even years later.”
sible concentration (10 picocunie of radon per By the time that the first 190 milligrams of
liter) of a radionudlide in the workroom atmo- plutonium had been separated (1944), it was

Volume 9, Number 6, Monograph November,

#{149} 1989 RadioGraphics
#{149} I 271
Historical development of radiation safety Brodsky and Kathren

already recognized that radiation hazards as- and regulating its use to “protect the health
sociated with pile operations were even more and safety of the public.”
insidious than had been suggested. Exposure The United States Public Health Service
to unirradiated natural uranium is not very dan- (PHS) also became active in promoting nadia-
gerous (contact dose rates with a slab of ura- tion protection programs. One result of the
niurn are 10 mR of gamma and 280 millirep of mass tuberculosis x-ray surveys of the mid-
beta per hour). Systemic plutonium was found 1940’s was an interest in diagnostic x-ray pro-
to be as hazardous as radium on a gram for tection. A comprehensive guide for the in-
gram basis. At the time, this was surprising spection of x-ray facilities in the Public Health
based on considerations of half life and ener- Service appeared in 1953 (14). At that time the
gy per disintegration. It was found that the PHS had no regulatory authority; its role was
greater hazard of plutonium was due to its limited to providing assistance in the form of
longer retention in bone and its preferential training, advice and research. The cumulative
deposition in a more critical region of bone. effect of these efforts was enormous: Many of
After the war, new impetus was given to the present generation of senior health physi-
radiation protection by the release of the re- cists and medical physicists were brought into
suIts of wartime research. The National Corn- the profession by means of PHS training grants.
mission on Radiation Protection (formerly the Model work on radiation protection, done ei-
USACXRP) published nineteen reports from then in abstract terms or in support of PHS facili-
1949 through 1960. Many of these directly con- ties, have been of seminal importance to the
cerned radiation protection in radiology. In radiological community. The Radiological
these reports, substantive conceptual Health Handbook was published to provide
changes in radiation protection philosophy equations, tables, graphs and maxims of use
were put forth. Tolerance dose gave way to to virtually anyone with involvement in radia-
the concept of maximum permissible dose, a tion protection. First published in 1952, it has
concept that did not necessarily imply a been revised and reprinted several times, the
threshold. The whole body maximum permissi- last being in 1970. One can hope that future
ble exposure, which had been set at 30 R per editions will continue to appear.
year in 1936, was reduced to 15 REM per year The PHS organized a Division of Radiologi-
in 1948 and 5 REM per year in 1958. The cal Health in 1959. Its original mission included
change in units was made necessary by the assessment of the dose delivered to the popu-
more complex radiological environment lation of the United States by medical proce-
present after the war. The concept of benefit dunes. The results of these ongoing studies re-
vs. risk was introduced. This was the forerunner suIted in the development of techniques for
of the “ALARA” (as low as reasonably achiev- eliminating unnecessary exposures by a van-
able) principle of exposure limitation that is in ety of means-educational as well as techno-
common use today. logical. In the modern era, Congress has as-
Radiation protection activities were fur- signed regulatory responsibility to this organi-
then stimulated by the production and distnibu- zation. It still continues its public health
tion of many new radionudlides, created in the tradition of service and education to a sub-
Oak Ridge graphite reactor, for medical re- stantial degree.
search and treatment as well as for industrial The enabling legislation for the Atomic Ener-
use. Standards were needed for maximum gy Commission was modified in 1954 to more
permissible concentrations and body burdens clearly separate promotional and regulatory
for all of these materials. The scope of these activities. Congress chose to keep these activ-
standards had to be expanded from the ities within a single agency to insure enough
needs of a few workers (the radium dial paint- competent technical staff for the tasks at
ens of the previous war) to those of entire pop- hand. This potential conflict of interest was of
ulations. Much of this work was performed un- concern to advisors to the Public Health Ser-
den the direction of the Atomic Energy Corn- vice, but there was no formal top level resolu-
mission (AEC). This body was given the dual tion of the organizational problem for another
responsibility of developing atomic energy fifteen years. At the working level, radionu-

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#{149} 1989 Volume 9, Number 6, Monograph
Brodsky and Kathren Historical development of radiation safety

clide inspection and licensure activities were Medical radiation protection has become
partially turned oven to the States, where they more complex with the increasing use of so-
were integrated with x-ray safety programs. phisticated diagnostic and therapeutic equip-
The NRCP, as vague in its charter as it was forty ment. Health physics activities have expanded
years earlier, provided expertise unavailable in to imaging methods such as sonognaphy and
government. In all, the general safety require- magnetic resonance imaging that do not use
ments developed in this era have worn well ionizing radiation. The basic principles eluci-
into the present. dated at the turn of the century still apply. The
In 1955, the first symposium exclusively de- modern era has also brought further increases
voted to radiation protection was held at Ohio in regulatory control: mandatory licensing of
State University. Attendees decided to form a radionudlides and machine sources of radia-
professional society (15). The name Health tion; requirements for improved education and
Physics Society was chosen and Karl Z. Morgan training of radiological staff; and the institution
was elected its first President. He then served of radiation protection programs based on
as the editor of the society’s journal for the ALARA (the principle of keeping radiation ex-
next twenty years. With the birth of the Health posures as low as reasonably achievable). Ac-
Physics Society, radiation protection became creditation programs focus some of their at-
an established and independent profession. tention on the appropriate use of quality irn-
The society has grown to a present member- aging as well as the control of radiation
ship of 6,500. exposure of patients, staff and visitors.
The Atomic Energy Commission was broken
The Modern Era up in 1975. Activities relating to the promotion
(1 960-Present) of the technology were assigned to the De-
partrnent of Energy. Regulatory authority was
The modern era can not be treated in assigned to the newly formed United States
complete perspective. What has happened in Nuclear Regulatory Commission (NRC). While
the past three decades has not yet stood the both agencies continue the tradition of sub-
test of time. There has been an enormous in- stantial research and assistance in radiation
crease in the number of new and revised stan-’ protection, the work of the Occupational Ra-
dards, guidelines, reference works, and negula- diation Protection Branch, directed by Robert
tions. In 1971, the growth rate in radiation pro- E. Alexander, at the NRC is of particular note. A
tection standards was so rapid that Parker continuing series of guidelines to acceptable
challenged an audience to “. determine
. . the practice have been published by this organi-
year at which the sole occupation of the zation in the last fifteen years. Many of these
health physicist becomes the reading of pro- are most helpful in radiation oncology, nuclear
tection handbooks.” To many, we are well on medicine and to a degree in radiology (16).
the way toward that year, if not already there. A list of these documents is available from
The NCRP by itself has about 70 current hand- the NRC, Office of Nuclear Regulatory
books. Only a fraction of these relate directly Research.
to radiology, but those that do offer rather The Public Health Service has continued its
comprehensive design and operational nec- programs that provide advice and assistance
ommendations for most areas of radiological to the public, States and medical professions.
and nuclear medicine practice. Excellent An x-ray protection laboratory was established
guidance in the emergency management of in 1960, which still performs accurate instru-
patients who have been exposed to radioac- ment calibration services for many State
tive materials is also provided in the NCRP re- agencies and other facilities. This agency is
ports. These documents represent the dedi- the “keeper of the national dose” through its
cated cooperation of many individuals within periodic surveys of medical, dental, and other
the radiological, medical physics, and health exposures. As a result of these measurements,
physics communities. A list of NCRP reports can a need for improved quality assurance as a
be obtained from NCRP Publications (Washing- means of dose reduction was identified. Ap-
ton, DC). propniate programs were developed either in-

Volume 9, Number 6, Monograph November,

#{149} 1989 RadioGraphlcs
#{149} I 273
Historical development of radiation safety Brodsky and Kathren

house or under its sponsorship and promoted in and of the intake of radioactive materials.
the user communities. The passage of the Pa- (4) The professions will then realize that
diation Control for Health and Safety Act, in currently assumed risks of exposure and con-
1969, resulted in the agency’s assumption of tarnination provide much greaten safety fac-
regulatory responsibilities for imaging equip- tons than are generally realized. These safety
ment performance in 1969. Its previous inter- factors may be great enough to absorb the
ests in environmental protection were trans- uncertainty in radiation risk estimates.
ferred to the newly created Environmental Pro- (5) Emphasis will then shift away from risks
tection Agency at that time. to the public back to radiation protection of
It is evident that an article of limited length the worker.
can not deal adequately with all of the politi- The resources that can be spent on public
cal and scientific history that has influenced health are finite. Radiation is only one of sever-
the relationships between various voluntary al environmental agents worthy of the expen-
and governmental programs in the develop- diture of resources. It is to be hoped that those
rnent of radiation protection standards in our of us involved in both radiological and radia-
complex society. The unusual degree of coop- tion protection activities will begin to hone our
enation and goodwill that has developed be- own knowledge of radiation risks, so that we
tween organizations and individuals in the can adequately allay undue public fears of
quest for the common goal is remarkable. low levels of radiation. We must be able to as-
sure members of the public that adequate ra-
diation protection is truly provided. This is pen-
The Future
haps the biggest challenge of health physics.
Our own crystal ball, formed through the
work on this paper, reveals the following future References
needs and developments:
(I) Concepts of “de rninirnus” and “be- 1. Roentgen WC. On a new kind of rays. Nature 1896;
53:274-276.
low regulatory concern” will be incorporated
2. Hodges PC. The life and times of Emil Grubbe. Chico-
into the regulatory system. This will permit the go: University of Chicago Press, 1964.
deployment of resources into areas in which 3. Kathren RL. Early x-ray protection in the United States.
the benefit-cost ratio indicates some real re- Health Phys 1962; 8:503-511.
suIts could be obtained. 4. Dyer FL. Martin TO. Meadowcroft WH. Edison: His life
and inventions. Harpers 1929; 2:58 1.
(2) The concept of radiation hormesis1
5. Thompson E. Roentgen rays act strongly on the tissues.
should be studied. This is a difficult area in Elect Eng 1986; 22:534.
which to even attempt to predict the nature 6. MacKee GM. X-rays and radium in the treatment of
of the required studies and expected results. If diseases of the skin. Philadelphia: Lea & Febiger. 1927.
the concept of radiation honmesis is supported 7. Dennis J. The Roentgen energy today. Dental Cosmos
1899; 41:853.
by further study, it represents a beneficial ef-
8. Kathren RL. William Herbert Rollins (1852-1929): X-ray
fect separate from radiation damage mecha- protection pioneer J Hist Med 1964; 19:287-294.
nisms, and suggests that there is some radia- 9. Rollins WH. Notes on x-Iight. Boston: privately printed,
tion level below which presumed beneficial re- 1904.
suIts of low level radiation exposure 10. Mutscheller A. More on x-ray protection standards. Ra-
diology 1934; 10:739.
overbalance the risks.
I I . Taylor LS. Organization for radiation protection: The
(3) Advantage will be taken of routine sun- operations of the ICRP and NCRP 1928-1974. Report
vey data and of natural phenomena to calcu- no. DOE/TIC-10124. Washington. DC: U.S. Department
late realistic probabilities of radiation exposure of Energy, 1982.

I Hormesis: The concept that in very low doses, a toxic agent such as ionizing radiation may be beneficial rather than
harmful to living organisms.

I 274 RadioGraphics November,

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#{149} 9, Number 6, Monograph
 Brodsky and Kathren Historical development of radiation safetys

12. Stannard JN. Radioactivity and health: A history. Rich- 15. Kothren RL. Ziemer PL. Introduction: The first fifty years
land, Wash: Battelle Memorial Institute, Pacific North- of radiation protection-A brief sketch. In: Kathren RL.
west Laboratory, 1988. ed. Health physics: A backward glance. Elmsford, NY:
13. Morgan KZ. Radiation: Protection and health physics. Pergamon. 1980; 1-9.
In: Glasser, ed. Medical physics. Chicago: Yearbook 16. McElroy NL, Brodsky A. Radiation protection training for
Medical, 1950; 766-774. personnel employed in medical facilities. USNRC publi-
14. Ingraham SC II. Terrill JG Jr. Moeller DW. Guide for in- cation no. NUREG-0938, Washington, DC: USNRC, 1985.
spection of medical and dental diagnostic x-ray instal-
lotions in the public health service. U.S. Public Health
Service Publication BSS/DER/RHB. Washington, DC: U.S.
Public Health Service, 1953.

Volume 9, Number 6, Monograph November,

#{149} 1989 RadloGraphics
#{149} I 275

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