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COMMON SENSE APPROACH TO THE PROBLEM OF GENETIC HAZARD DUE TO DIAGNOSTIC RADIOLOGY: Title and subTitle BreakREPORT BASED IN PART ON STUDY OF EXPOSURES IN A SMALL AMERICAN INDUSTRIAL CITY FREE

W. Daggett Norwood, M.D.
[+] Author Affiliations

Read before the Annual Industrial Health Conference, Atlantic City, N. J., April 23, 1958.


Richland, Wash.

Manager, Health and Safety Operation, Hanford Atomic Products Operation, operated by General Electric Company for the Atomic Energy Commission.


JAMA. 1958;167(16):1928-1935. doi:10.1001/jama.1958.72990330004007
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Accumulating evidence suggests that the genetic damage to the human gonads due to exposure to ionizing radiation is greater than previously thought. This, with the greater potential for exposure of whole populations in medicine, industry, and defense, has resulted in increasing concern over genetic injury to whole populations. Debates among scientists over the amount and effect of radiation due to fall-out from testing atomic weapons have made the American public more aware of the hazards of radiation. This is a healthy state of affairs, if perspective can be maintained on the part of both the medical profession and the public.

Considering the relative genetic hazards to whole populations from man-made radiation, we find that by far the largest contribution comes from diagnostic radiology. At the same time, the judicious use of diagnostic radiology is one of medicine's most important tools.

Much remains to be learned regarding the actual exposures being

REFERENCES

Quimby, E. H.:  Radiation Hazards and What Is Being Done About Them—Symposium: Introduction and Statement of Problem , Am. J. Roentgenol. 78:944-945 ( (Dec.) ) 1957;.
Norwood, W. D.; Healy, J. W.; Donaldson, E. E.; Roesch, W. C.; and Kirklin, C. W.: Genetically Significant Radiation Dose Received by People of Small American City due to Diagnostic Use of X-rays, to be published
Biological Effects of Atomic Radiation: Summary Report from study by National Academy of Sciences , Washington, D. C., National Research Council, 1956;.
Hazards to Man of Nuclear and Allied Radiations, report of Medical Research Council, London, Her Majesty's Stationery Office, June, 1956.
Crow, J. S.:  Genetic Considerations in Establishing Maximum Radiation Doses , Radiology 69:18-22 ( (July) ) 1957;.
Glass, B.:  Genetic Basis for Limitation of Radiation Exposure , Am. J. Roentgenol. 78:955-959 ( (Dec.) ) 1957;.
Muller, H. J., and Mott-Smith, L. M.:  Evidence That Natural Radioactivity Is Inadequate to Explain Frequency of "Natural" Mutations , Proc. Nat. Acad. Sc. 16:277-285, 1930;.
Muller, H. J.:  Nature of Genetic Effects Produced by Radiation , in Radiation Biology , edited by A. Hollaender and others, National Research Council, New York, McGraw-Hill Book Company, Inc., 1954;, vol. 1, chap. 7.
Neel, J. V.:  Delayed Effects of Ionizing Radiation , J. A. M. A. 166:908-916 ( (Feb. 22) ) 1958;.
Russell, W. L.:  Genetic Effects of Radiation in Mammals , in Radiation Biology , edited by A. Hollaender and others, National Research Council, New York, McGraw-Hill Book Company, Inc., 1954;, vol. 1, chap. 12.
Spencer, W. P., and Stern, C.:  Experiments to Test Validity of Linear r-Dose/Mutation Frequency Relations in Drosophila at Low Dosage , Genetics 33:43-74 ( (Jan.) ) 1948;.
Ehrenberg, L.; Von Ehrenstein, G.; and Hedgran, A.:  Gonad Temperature and Spontaneous Mutation-Rate in Man , Nature 180:1433-1434 ( (Dec. 21) ) 1957;.
Failla, G., and McClement, P.:  Shortening of Life by Chronic Whole-Body Irradiation , Am. J. Roentgenol. 78:946-954 ( (Dec.) ) 1957;.
Failla, G.:  Considerations Bearing on Permissible Accumulated Radiation Doses for Occupational Exposure: Aging Process and Cancerogenesis , Radiology 69:23-29 ( (July) ) 1957;.
Warren, S.:  Longevity and Causes of Death from Irradiation in Physicians , J. A. M. A. 162:464-468 ( (Sept. 29) ) 1956;.
Lewis, E. B.:  Leukemia and Ionizing Radiation , Science 125:965-972 ( (May 17) ) 1957;.
Braestrup, C. B.:  Past and Present Radiation Exposure to Radiologists from Point of View of Life Expectancy , Am. J. Roentgenol. 78:988-992 ( (Dec.) ) 1957;.
Jones, H. B.: Estimation of Effect of Radiation upon Human Health and Life Span , Proceedings of Health Physics Society, (June) , 1956;.
Blair, H. A.: Formulation of Injury, Life Span, Dose Relations for Ionizing Radiation: Application to Mouse, UR-206 , University of Rochester Atomic Energy Project, (May) , 1952;
Blair, H. A.: Application to Guinea Pig, Rat, and Dog, UR-207 , University of Rochester Atomic Energy Project (July) , 1952;
Recovery from Radiation Injury in Mice and Its Effect on LD50 for Durations of Exposure up to Several Weeks , UR-312, (Feb.) , 1954;.
Henshaw, P. S.:  Genetic Transition as Determinant of Physiologic and Radiologic Aging and Other Conditions , Radiology 69:30-36 ( (July) ) 1957;.
Taylor, L. S.:  Current Situation with Regard to Permissible Radiation Exposure Levels , Radiology 69:6-11 ( (July) ) 1957;.
 Maximum Permissible Radiation Exposures to Man: Preliminary Statement of National Committee on Radiation Protection and Measurement , Radiology 68:260-261 ( (Feb.) ) 1957;.
Lincoln, T. A., and Gupton, E. D.:  Radiation Dose to Gonads from Diagnostic X-ray Exposure , J. A. M. A. 166:233-239 ( (Jan. 18) ) 1958;.
Ardran, G. M., and Crooks, H. E.:  Gonad Radiation Dose from Diagnostic Procedures , Brit. J. Radiol. 30:295-297 ( (June) ) 1957;.
Blatz, H. H., and Lawder, W. M.: Gonadal Dose in Roentgen Examinations : Literature Search, New York, Health and Safety Laboratory, U. S. Atomic Energy Commission, New York Operations Office, (Sept.) , 1956;.
Clark, S. H.:  Genetic Radiation Exposures in Field of Medicine , Bull. Atomic Scientists 12:14-18 ( (Jan.) ) 1956;.
Clayton, C. G.: Farmer, F. T.; and Warrick, C. K.:  Radiation Doses to Foetal and Maternal Gonads in Obstetric Radiography During Late Pregnancy , Brit. J. Radiol. 30:291-294 ( (June) ) 1957;.
Handloser, J. S., and Love, R. A.:  Radiation Doses from Diagnostic X-ray Studies , Radiology 57:252-254 ( (Aug.) ) 1951;.
Laughlin, J. S., and Pullman, I.: Biological Effects of Atomic Radiation: Gonadal Dose Produced by Medical Use of X-rays—Preliminary Report from Study by National Academy of Sciences , Washington, D. C., National Research Council, (March) , 1957;.
Laughlin, J. S.; Meurk, M. L.; Pullman, I.; and Sherman, R. S.:  Bone, Skin, and Gonadal Doses in Routine Diagnostic Procedures , Am. J. Roentgenol. 78:961-982 ( (Dec.) ) 1957;.
Martin, J. H.:  Radiation Doses to Gonads in Diagnostic Radiology and Their Relation to Long-term Genetic Hazard , M. J. Australia 2:806-810 ( (Nov. 12) ) 1955;.
Osborn, S. B., and Smith, E. E.:  Genetically Significant Radiation Dose from Diagnostic Use of X-rays in England and Wales: Preliminary Survey , Lancet 1:949-953 ( (June 16) ) 1956;.
Reference 17f and g.
References 2 and 17f.
Radiation Safety and Major Activities in Atomic Energy Programs, July-Dec., 1956, report of United States Atomic Energy Commission, 1956. Nature of Radioactive Fallout and Its Effects on Man, report of Special Subcommittee on Radiation, Joint Committee on Atomic Energy, Eighty-fifth Congress of the United States, 1957, parts 1 and 2, pp. vii and 2065.
Taylor, L. S.:  Practical Suggestions for Reducing Radiation Exposure in Diagnostic Examinations , Am. J. Roentgenol. 78:983-987 ( (Dec.) ) 1957;.
Trout, E. D.; Kelley, J. P.; and Cathey, G. A.:  Use of Filters to Control Radiation Exposure to Patient in Diagnostic Roentgenology , Am. J. Roentgenol. 67:946-963 ( (June) ) 1952;.
Trout, E. D.; Graves, D. E.; and Slauson, D. B.:  High-Kilovoltage Radiography , Radiology 52:669-683 ( (May) ) 1949;.
Stanford, R. W., and Vance, J.:  Quantity of Radiation Received by Reproductive Organs of Patients During Routine Diagnostic X-ray Examinations , Brit. J. Radiol. 28:266-273 ( (May) ) 1955;.
Gasque, M. R.:  Shielding Device to Protect Gonads During Routine Chest Roentgenography , Indust. Med. 27:79 ( (Feb.) ) 1958;.
X-ray Protection: Recommendations of National Committee on Radiation Protection , U. S. Department of Commerce, National Bureau of Standards, Handbook 60, (Dec.) , 1955;.
Bewley, D. K.; Laws, J. W.; and Myddleton, C. J.:  Maternal and Foetal Radiation Dosage During Radiographic Examinations , Brit. J. Radiol. 30:286-290 ( (June) ) 1957;.
Stone, R. S.:  Common Sense in Radiation Protection Applied to Clinical Practice , Am. J. Roentgenol. 78:993-999 ( (Dec.) ) 1957;.
Buschke, F., and Parker, H. M.:  Possible Hazards of Repeated Fluoroscopies in Infants , J. Pediat. 21:524-533 ( (Oct.) ) 1942;.
Sonnenblick, B. P.:  X-ray Exposure in Routine Diagnostic Practice: Survey of 117 Fluoroscopes , Rec. Genet. Soc. A. 21:71, 1952;.
Chamberlain, R. H.:  Summary: Today's Problems in Radiation Hazards and What Is Being Done to Control Them , Am. J. Roentgenol. 78:1000-1002 ( (Dec.) ) 1957;.
Moeller, D. W.; Terrill, J. G., Jr.; and Ingraham, S. C., II:  Radiation Exposure in United States , Public Health Rep. 68:57-65 ( (Jan.) ) 1953;.

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Quimby, E. H.:  Radiation Hazards and What Is Being Done About Them—Symposium: Introduction and Statement of Problem , Am. J. Roentgenol. 78:944-945 ( (Dec.) ) 1957;.
Norwood, W. D.; Healy, J. W.; Donaldson, E. E.; Roesch, W. C.; and Kirklin, C. W.: Genetically Significant Radiation Dose Received by People of Small American City due to Diagnostic Use of X-rays, to be published
Biological Effects of Atomic Radiation: Summary Report from study by National Academy of Sciences , Washington, D. C., National Research Council, 1956;.
Hazards to Man of Nuclear and Allied Radiations, report of Medical Research Council, London, Her Majesty's Stationery Office, June, 1956.
Crow, J. S.:  Genetic Considerations in Establishing Maximum Radiation Doses , Radiology 69:18-22 ( (July) ) 1957;.
Glass, B.:  Genetic Basis for Limitation of Radiation Exposure , Am. J. Roentgenol. 78:955-959 ( (Dec.) ) 1957;.
Muller, H. J., and Mott-Smith, L. M.:  Evidence That Natural Radioactivity Is Inadequate to Explain Frequency of "Natural" Mutations , Proc. Nat. Acad. Sc. 16:277-285, 1930;.
Muller, H. J.:  Nature of Genetic Effects Produced by Radiation , in Radiation Biology , edited by A. Hollaender and others, National Research Council, New York, McGraw-Hill Book Company, Inc., 1954;, vol. 1, chap. 7.
Neel, J. V.:  Delayed Effects of Ionizing Radiation , J. A. M. A. 166:908-916 ( (Feb. 22) ) 1958;.
Russell, W. L.:  Genetic Effects of Radiation in Mammals , in Radiation Biology , edited by A. Hollaender and others, National Research Council, New York, McGraw-Hill Book Company, Inc., 1954;, vol. 1, chap. 12.
Spencer, W. P., and Stern, C.:  Experiments to Test Validity of Linear r-Dose/Mutation Frequency Relations in Drosophila at Low Dosage , Genetics 33:43-74 ( (Jan.) ) 1948;.
Ehrenberg, L.; Von Ehrenstein, G.; and Hedgran, A.:  Gonad Temperature and Spontaneous Mutation-Rate in Man , Nature 180:1433-1434 ( (Dec. 21) ) 1957;.
Failla, G., and McClement, P.:  Shortening of Life by Chronic Whole-Body Irradiation , Am. J. Roentgenol. 78:946-954 ( (Dec.) ) 1957;.
Failla, G.:  Considerations Bearing on Permissible Accumulated Radiation Doses for Occupational Exposure: Aging Process and Cancerogenesis , Radiology 69:23-29 ( (July) ) 1957;.
Warren, S.:  Longevity and Causes of Death from Irradiation in Physicians , J. A. M. A. 162:464-468 ( (Sept. 29) ) 1956;.
Lewis, E. B.:  Leukemia and Ionizing Radiation , Science 125:965-972 ( (May 17) ) 1957;.
Braestrup, C. B.:  Past and Present Radiation Exposure to Radiologists from Point of View of Life Expectancy , Am. J. Roentgenol. 78:988-992 ( (Dec.) ) 1957;.
Jones, H. B.: Estimation of Effect of Radiation upon Human Health and Life Span , Proceedings of Health Physics Society, (June) , 1956;.
Blair, H. A.: Formulation of Injury, Life Span, Dose Relations for Ionizing Radiation: Application to Mouse, UR-206 , University of Rochester Atomic Energy Project, (May) , 1952;
Blair, H. A.: Application to Guinea Pig, Rat, and Dog, UR-207 , University of Rochester Atomic Energy Project (July) , 1952;
Recovery from Radiation Injury in Mice and Its Effect on LD50 for Durations of Exposure up to Several Weeks , UR-312, (Feb.) , 1954;.
Henshaw, P. S.:  Genetic Transition as Determinant of Physiologic and Radiologic Aging and Other Conditions , Radiology 69:30-36 ( (July) ) 1957;.
Taylor, L. S.:  Current Situation with Regard to Permissible Radiation Exposure Levels , Radiology 69:6-11 ( (July) ) 1957;.
 Maximum Permissible Radiation Exposures to Man: Preliminary Statement of National Committee on Radiation Protection and Measurement , Radiology 68:260-261 ( (Feb.) ) 1957;.
Lincoln, T. A., and Gupton, E. D.:  Radiation Dose to Gonads from Diagnostic X-ray Exposure , J. A. M. A. 166:233-239 ( (Jan. 18) ) 1958;.
Ardran, G. M., and Crooks, H. E.:  Gonad Radiation Dose from Diagnostic Procedures , Brit. J. Radiol. 30:295-297 ( (June) ) 1957;.
Blatz, H. H., and Lawder, W. M.: Gonadal Dose in Roentgen Examinations : Literature Search, New York, Health and Safety Laboratory, U. S. Atomic Energy Commission, New York Operations Office, (Sept.) , 1956;.
Clark, S. H.:  Genetic Radiation Exposures in Field of Medicine , Bull. Atomic Scientists 12:14-18 ( (Jan.) ) 1956;.
Clayton, C. G.: Farmer, F. T.; and Warrick, C. K.:  Radiation Doses to Foetal and Maternal Gonads in Obstetric Radiography During Late Pregnancy , Brit. J. Radiol. 30:291-294 ( (June) ) 1957;.
Handloser, J. S., and Love, R. A.:  Radiation Doses from Diagnostic X-ray Studies , Radiology 57:252-254 ( (Aug.) ) 1951;.
Laughlin, J. S., and Pullman, I.: Biological Effects of Atomic Radiation: Gonadal Dose Produced by Medical Use of X-rays—Preliminary Report from Study by National Academy of Sciences , Washington, D. C., National Research Council, (March) , 1957;.
Laughlin, J. S.; Meurk, M. L.; Pullman, I.; and Sherman, R. S.:  Bone, Skin, and Gonadal Doses in Routine Diagnostic Procedures , Am. J. Roentgenol. 78:961-982 ( (Dec.) ) 1957;.
Martin, J. H.:  Radiation Doses to Gonads in Diagnostic Radiology and Their Relation to Long-term Genetic Hazard , M. J. Australia 2:806-810 ( (Nov. 12) ) 1955;.
Osborn, S. B., and Smith, E. E.:  Genetically Significant Radiation Dose from Diagnostic Use of X-rays in England and Wales: Preliminary Survey , Lancet 1:949-953 ( (June 16) ) 1956;.
Reference 17f and g.
References 2 and 17f.
Radiation Safety and Major Activities in Atomic Energy Programs, July-Dec., 1956, report of United States Atomic Energy Commission, 1956. Nature of Radioactive Fallout and Its Effects on Man, report of Special Subcommittee on Radiation, Joint Committee on Atomic Energy, Eighty-fifth Congress of the United States, 1957, parts 1 and 2, pp. vii and 2065.
Taylor, L. S.:  Practical Suggestions for Reducing Radiation Exposure in Diagnostic Examinations , Am. J. Roentgenol. 78:983-987 ( (Dec.) ) 1957;.
Trout, E. D.; Kelley, J. P.; and Cathey, G. A.:  Use of Filters to Control Radiation Exposure to Patient in Diagnostic Roentgenology , Am. J. Roentgenol. 67:946-963 ( (June) ) 1952;.
Trout, E. D.; Graves, D. E.; and Slauson, D. B.:  High-Kilovoltage Radiography , Radiology 52:669-683 ( (May) ) 1949;.
Stanford, R. W., and Vance, J.:  Quantity of Radiation Received by Reproductive Organs of Patients During Routine Diagnostic X-ray Examinations , Brit. J. Radiol. 28:266-273 ( (May) ) 1955;.
Gasque, M. R.:  Shielding Device to Protect Gonads During Routine Chest Roentgenography , Indust. Med. 27:79 ( (Feb.) ) 1958;.
X-ray Protection: Recommendations of National Committee on Radiation Protection , U. S. Department of Commerce, National Bureau of Standards, Handbook 60, (Dec.) , 1955;.
Bewley, D. K.; Laws, J. W.; and Myddleton, C. J.:  Maternal and Foetal Radiation Dosage During Radiographic Examinations , Brit. J. Radiol. 30:286-290 ( (June) ) 1957;.
Stone, R. S.:  Common Sense in Radiation Protection Applied to Clinical Practice , Am. J. Roentgenol. 78:993-999 ( (Dec.) ) 1957;.
Buschke, F., and Parker, H. M.:  Possible Hazards of Repeated Fluoroscopies in Infants , J. Pediat. 21:524-533 ( (Oct.) ) 1942;.
Sonnenblick, B. P.:  X-ray Exposure in Routine Diagnostic Practice: Survey of 117 Fluoroscopes , Rec. Genet. Soc. A. 21:71, 1952;.
Chamberlain, R. H.:  Summary: Today's Problems in Radiation Hazards and What Is Being Done to Control Them , Am. J. Roentgenol. 78:1000-1002 ( (Dec.) ) 1957;.
Moeller, D. W.; Terrill, J. G., Jr.; and Ingraham, S. C., II:  Radiation Exposure in United States , Public Health Rep. 68:57-65 ( (Jan.) ) 1953;.
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