On page 6, you said: "It is worth noting that exposures of this kind," referring to medical radiation, "have always been specifically exempted from radiation regulations.'

Is that just a comment that you are making, or do you have a recommendation with respect to that, as well?

Dr. WHIPPLE. As it stands, it is a statement of fact, but it seems to me that it recognizes a fundamental truth, that future regulations must also recognize, and that is that it is inconceivable, to me at least, that one should attempt by regulations to limit what a physician in his judgment may give to a patient in the course of an examination or therapy. I cannot see that regulations have any place in this area.

Representative BATES. That is providing, of course, that the doctors are aware of the dangers inherent in radiation. I presume the judgment they must make is on the danger of losing a life from other purposes, or a hope of saving a life by exposing them to this particular danger. So there is a balance that they must strike.

But my question is: You say it is a truth. Is it also a danger? Do you feel that doctors generally are sufficiently advised of the inherent dangers of radiation, so that they can exercise proper judgment on this?

Dr. WHIPPLE. To the degree that they are not sufficiently informed, I cannot feel that the answer is regulation. The thing I would like to point out is that the question you have raised with regard to radiation in the hands of a physician is exactly that, that a physician has with almost everything he uses, drugs, any kind of therapy. He must in his judgment balance the possible risk to the patient against the possible gain to the patient. And in this, radiation is no different than many of the other things that the physician is called upon to administer to his patients.

Representative BATES. His judgment is only as good as his knowledge. My question is: Does he have sufficient knowledge in this particular field for passing judgment? I am speaking generally, now. Are you satisfied that throughout the country doctors who are using radiation of one kind or another have a sufficient knowledge of the subject so that they can pass adequate judgment on this matter?

Dr. WHIPPLE. I am sure that there are cases where many people in this room would say that in a given instance a physician was not sufficiently well informed.

Representative BATES. Then you say that we should not have regulations which would protect the public. Certainly we would not contend that the public should not be protected.

Dr. WHIPPLE. No, sir.

Representative BATES. In which form do you feel they should be advised of the inherent dangers? And if it is not by regulation, how will you get the word to them?

Dr. WHIPPLE. It seems to me the way this will be done, and it is a slow process, I know, is in the education that prepares a doctor for the practice of medicine. Just as he learns the things he must know in balancing gains and losses in the other elements; these he learns in his training. And I think radiation should be an integral part of the medical education. This, I think, is the way to meet this problem.

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Representative BATES. You feel it should be handled in that way. Now my question is: Do you feel that it is properly handled in that way? This is not a new field?

Ďr. WHIPPLE. No, it is not.

Representative BATES. Do you feel that the medical profession is pursuing this with the maximum amount of diligence in order to protect the public? That is what I am trying to find out.

Dr. WHIPPLE. I would certainly not say that it was perfect. I am not in a position to know in detail all of the medical programs. Dr. Dunham, who is on this morning, I am sure can give you a better answer to this question than I.

Representative BATES. Fine. Thank you.

Mr. RAMEY. It is possible to have voluntary codes established by groups like your NCRP and others, that set standards, that your medical people, for example, could follow, and by other educational means cut down on such amounts of exposure. As a matter of fact, I think that is going on. You see in the papers and so on criticisms of the amounts of exposure in individuals, and that the medical profession is getting much more aware of the need for cutting down on the excessive use of radiation.

Dr. WHIPPLE. Certainly the great value of regulations in this as in many other connections is their educational value in informing people of the standards and the problems.

Representative BATES. But you believe that is outside your jurisdiction, so you do not feel able to qualify yourself as a witness on that particular point?

Dr. WHIPPLE. You have many more competent witnesses in these areas than I in the room.

Mr. TOLL. Dr. Whipple, you pointed out various types of radiation. It might be well to indicate for the purposes of these hearings at this point that not all of these radiation sources are regulated by the same governmental bodies. AEC regulates only activities licensed by it, and does not regulate medical X-rays. AEC does not regulate natural radiation sources, such as radium, nor radiation from accelerators. These sources are left to regulation by State and local agencies.

Now, do you think this is a workable division, or should some sort of change in allocation of responsibilities be considered, in your opinion?

Dr. WHIPPLE. Speaking as a scientist, and not as a lawyer, as I must, I will say that this division, between the radiations and materials that fall within the responsibility of the Atomic Energy Commission and the other sources that fall outside of this, is a very unnatural one; and neither the human body nor many of our instruments can distinguish between an AEC-produced isotope and a cyclotron-produced isotope. And to this extent it is a puzzling and unsatisfactory division.

Representative DURHAM. It would be very difficult, I imagine, Doctor, to identify it, if you had to go to court, to prove a case, as to where it came from.

Dr. WHIPPLE. It would be extremely difficult.

Representative DURHAM. Again thank you very much, Doctor. You certainly gave us a fine paper, and we appreciate it very much. Representative DURHAM. The next witness is Dr. Lauriston Taylor, chairman of the National Committee on Radiation Protection.

Mr. Taylor, we are always glad to have you back with us. we have to call on you a lot now.

It seems

You may proceed with your statement. I see you have a prepared statement.

STATEMENT OF DR. LAURISTON S. TAYLOR, CHAIRMAN, NATIONAL COMMITTEE ON RADIATION PROTECTION

Mr. TAYLOR. Thank you.

Mr. Durham, it is a pleasure to be able to appear again before your committee in order to explain another phase of the work of the National Committee on Radiation Protection. This phase will have to do with its activity in the area of radiation protection regulations, such as might be used by State agencies or even by the Federal Government.

I would like to apologize, because I have not been able to give you more copies of this statement. Time has prevented it, over the last few days.

I will not go into any discussion about the background and the work of the AEC, since I believe this has been adequately covered in previous hearings this spring, and perhaps reference may be made to the material that has already been submitted in connection with these earlier hearings.

The material which I will discuss later is based on the recommendations of the National Committee on Radiation Protection and the International Commission on Radiological Protection. There is no official relationship between these two bodies, but there is some overlap of membership and they have always worked in the closest of harmony. In fact, there is no basic difference between the recommendations of these two bodies. Their recommendations are frequently couched in different terms and often one body will deal with matters not touched upon by the other. Wherever both bodies deal with the same matters their recommendations so far have without exception been in close accord.

From its inception, about 30 years ago, until about 7 years ago, the NCRP held fast to the attitude that it would be unwise to attempt to put its recommendations in the form or regulations that would presumably have to be enforced in detail. However, by 1952, it began to become evident that the situation in this regard was changing and that whether the NCRP liked it or not various bodies, State, national, and local would almost certainly be going ahead with the development of regulations for their own use. This became clearly evident ot the people in the Public Health Service who are beginning more and more often to receive requests from States as to how they should proceed in this matter. Because of these developments a conference was held about January 1953, between representatives from the Public Health Service, the American College of Radiology, American Medical Association, and the National Committee on Radiation Protection. As a result of these discussions the NCRP agreed to undertake a study of the problem in particular in relationship to the type of inquiries that were coming in to the PHS. I would like to explain at the outset that a project of this general type has always been regarded as somewhat out of character for the NCRP. In general the

NCRP develops philosophy and data of the type that might be needed in codes and regulations but almost without exception the committee has itself avoided the development of codes. Furthermore, the committee has not been in the practice of dealing in legislative, legal, or regulatory matters.

The program of radiation regulations was, however, started in order to meet a need that clearly was not being met in any other way or by any other group. It was felt that failure to do this would almost certainly result in a chaotic situation with many States developing conflicting regulations. The original policy with regard to this particular study was not to publish it but to make it available on demand. However, even before the report was finished, word about it had gotten around to the point where the immediate demand for it was much greater than we could expect to meet by the circulation of mimeograph copies. The published report was issued in December 1955, since which time the Government Printing Office has sold about 12,000 copies to the public.

At about the same time that the NCRP was working on the development of a philosophy and plan for radiation regulations, the AEC began their own work along very similar lines. It was determined from discussions with AEC people that their regulations would be designed to cover only those situations which came under their statutory authority. This meant that the AEC regulations would apply specifically to only some 5 percent of the total radiation insult to our people as a whole. The other 95 percent is produced by radiation sources not under AEC control. It was, therefore, the intent of the NCRP to develop a plan covering all sources of radiation without exception. This necessitated some considerations beyond those being contemplated by the AEC.

As I mentioned, in December 1955, the NCRP published its report entitled "Regulation of Radiation Exposure by Legislative Means." This was printed as NBS Handbook No. 61 and I would like to file a copy of this with the committee.

Representative DURHAM. We will be glad to have that publication on file.

(Excerpts from NBS Handbook No. 61 are reprinted on pp. 241269 of the Joint Committee print entitled "Selected Materials on Federal-State Cooperatiion in the Atomic Energy Field.")

Mr. TAYLOR. Thank you, sir.

The report consisted essentially of three parts. The first part consists of an overall discussion of the problem of radiation protection regulations, calling attention to advantages and disadvantages of certain courses of action. From this discussion the NCRP developed some conclusions of its own, and these were reflected in the more specific suggestions contained in the two appendices.

Appendix A of the report gave a suggested State Radiation Protection Act. This was designed in the main to cover those points that the committee felt to be more essential should any State not already have clearly defined ideas of its own. This legislative pattern was more or less along the lines of various other acts in other fields that have been found useful and workable by State health agencies.

The committee makes no pretense of being expert in legislative matters and now that other bodies have become active in this field the

committee intends to discontinue any direct interest in this aspect of its work. While I believe that the members of the committee by and large care less for the program proposed by the Council of State Governments than our own proposal in the 1955 handbook, we nevertheless will not attempt to promote further the suggestions contained in our original report.

Appendix B contained a set of suggested radiation protection regulations that we felt might be adaptable possibly with some minor technical changes by most States. These regulations essentially embodied a compilation of the most essential radiation protection features drawn from all of the past NCRP recommendations. They were designed to cover all kinds and sources of radiation. No very serious attempt was made to put these regulations in what would normally be regarded as acceptable legal style. On the other hand, the suggestions were in sufficiently good legal form as to be found usable by several States with virtually no change.

In preparing these suggested regulations, the NCRP itself has regarded them principally as a pattern. It has expected and hoped that anybody using them would examine them with care and make such changes as might be necessary in order to fit into their normal legal practices.

As a result of this early activity of the NCRP, it has been gratifying to find that the basic technical aspects of these regulations have been followed with a very high degree of uniformity by many States and by the AEC. I am unaware of any differences between any of the regulations developed by these groups that are of any great technical significance. There are some differences that may have legal significance, but even here I believe that for the most part they are relatively minor.

This high degree of uniformity has come about in part because even during the period when we were working on our own suggested regulations, we collaborated closely with the AEC and the various States who were engaged in similar projects. We supplied these groups with draft copies of our work as it developed. As a result we were able to profit by their experience and they were able to profit by ours. From time to time people looking for differences between things report that there are differences between the NCRP and State or Federal regulations. That there are differences is without question. Whether these are of any import or not is another matter. For example, Professor Frampton in his excellent paper on this question drew attention to a number of differences between the AEC and the suggested NCRP regulations. He was correct in the points that he developed. But I would like to emphasize that the technical differences to which he called attention were trivial and of no consequence. There were legal differences brought about in part because in any legal situation a problem has to be all black or all white. In making them all one way or the other, the AEC has been compelled for reasons which we well understand and appreciate, to be more specific in some areas where we think that such specificity is not technically valid. In spite of these differences, the basic concepts and the basic standards are identical.

The original committee preparing handbook 61 was made up mainly of radiation physicists, physicians, and Public Health officers. It also