vite ete OEE ne eleal RADIATION STANDARDS, INCLUDING FALLOUT 293 using radiation for medical purposes with a high degree of control of dosage, without unnecessary wastage, and with wise choice of indications for its use. Such considerations result in a progressive reduction of radiation dosage in achieving any given amount of good. The full utilization of present radiological methods for the maximum benefit of the population is not yet achieved and an inerease in volume of many studies is a desirable goal which will and should accompany the further advance of medical care. Most remarkable, however, is the recent great expansion in new studies and precedures which have not been available before. The accuracy of diagnosis, the guidance to appropriate surgery or other therapy, and the management of complications have been extended to phenomenal limits with such new precedures. For example, in a suspected renal tumor, the usual studies of a few years ago might well have been limited to a single plain film and perhaps three or four exposures during the excretion of a urographic contrast medium. In our large medical centers today this is commonly amplified with more conventional contrast films and renal arteriographic serial studies, perhaps more films with retroperitoneal gas injection, frequently elaborated with multiple body section K-ray films, and may be extended to venous contrast examinations and visualization of the lymphatic system. The value judgments as to when each procedure is indicated and to the benefits derived are not precisely definable, particularly in advance. The general prospect is clear, however, in that more and more of these elaborate techniques are needed, they furnish vital information, and they will be an increasingly important part of future medical practice. It would appear almost paradoxical that we sre striving to reduce radiation dosage while encouraging and welcoming large increases in it. The two objects should be sharply distinguished, however, for the first is to reduce unproductive radiation exposure, while the latter is to appreciate that medical benefits from indicated procedures, no matter how extensive, usually far outweigh the relatively small potential hazard from the radiation. The following summary points seem justified : 1. We do not know the exact extent of radiation exposure from medical use in the United States. It is probably smaller than indicated in earlier estimates, but is being constantly influenced toward reduction by improved techniques and control and toward increase by greater use of present methods and new de velopments in radiological diagnosis. The exact figure is probably not of great importance. 2. Medical groups have been commendably active in educational and voluntary control measures toward reducing unproductive medical radiation exposure. 3. State and other regulatory bodies have increased their activities in regulatory codes, and these have had a generally good effect when carefully administered. 4, New research developments are expanding the potential of human benefits from medical radiological procedures and many incorporate desirable dose reduction potentialities, 5. The best needs of our people are likely to be served by expanded medica} use of radiation, without prejudged limits as to its extent, but with intelligent and informed control of the radiation used. TABLE A.—Survey of the members and fellowes of the American College of Radiology on radiation protection, safety and contral d cn responding | | Number of talks, speeches, and programs civen personally Number of other such programs known to have been ziven | | Estimate of percentage improvement in medical radiation protection None 2,545 13, 211 27, 156 37 _t 50 per-[ 75 per-| Other 10 per-| 25 percent cent 338 554 or oer and editorials prepared personally | cent cent 817 331 27 1, 687 re SERRETRARRESTBITSBSOTEEhegSRR HEHEHE ‘c 7 . ae os + 1 1 or mee