288 RADIATION STANDARDS, INCLUDING FALLOUT tional fluoroscopy by their members, reserving it for problem cases, and then done by people especially trained in it. Similar efforts have been done by the Academy of Gynecology and Academy of Dermatology. In looking at the impact of regulatory codes which the greatest numberof States either already have put into effect or are planning to do, I think that we could say that most of these have been moderate measures and have been very well conceived. Most of them are based on the National Committee of Radiation Protection recommendations, and have had a generally favorable impact. There are difficulties in trying to elaborate these codes, particularly in medicine. Someof this is because what looks like a sensible recommendation for most instances may actually be a great hindrance in a specific small group. I have given one example of such, but in most instances the codes have been very good. As an example of how effective regulatory codes have been, again onan opinion, but an informed—and I think a highly informed— opinion, Dr. Blatz, who has been most active in this field in the city of New York, estimates that his regulatory code activities have been instrumental in producing about a 25-percent reduction in radiation exposure in the past 3 years in New York City. Many other cities have had voluntary programs from their medica] and dental groups working in conjunction with the official State or other local government. Another major influence on the medical picture is what is going on in research and in the development of new techniques. I think that diagnostic radiology, far from being a fairly stable development in medicine nov,is still in its relative infancy, or certainly not past adolescence. We are bringing to bear in dose reduction now, just beginning to bring to bear, some of the real fruits of television and electronic research systems, so that. amplified fluoroscopes are now coming into wide use in large departments. As they become more stabilized in design, and with some further improvements, I am sure they will be used even more widely. These machines allow us to do procedures quite regularly at one-tenth of previous radiation dosage values, and in some instances up to an improvement of one-hundredth of the original dosage values. Also new materials are being developed for intensifying screens and a variety of other minor improvements, but nevertheless important ones, in such things as the speed of X-ray films. I don’t know where this is going to Jead us finally but quite likely we can do an appreciable amountof the work which we are doing now at still lower dosages in the future. But operating against this so far as dose reduction is concerned, is the increasing use of radiological procedures. I don’t think we are yet saturated in the country for the present procedures. It is quite likely that we need to do a much greater volume. Ty own estimate would be at Jeast three or four times the volume of present procedures. Even more remarkable is what is going on in new procedures, Vhe patient that used to come to a hospital and have one or two examinations performed, now has perhaps as many as 8 or 10 radiological procedures directed to the same part of the body in order to find out not the same as we used to find ont but much more than we usedto find out. This allows us to direct his treatment, his operations, and 4,EEREadaheahadOSSHE Seater ele