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the District of Columbia had formally recognized, and moved to meet, their responsibilities in the field of radiation control.

Since medical and dental X-rays contribute a major share of the total radiation exposure to the individual, Federal-State survey programs have been initiated in a number of States to determine characteristics of the design and use of diagnostic X-ray units that cause unnecessary radiation exposure to patients and/or physicians and technicians. In the past 3 years, program emphasis has been on dental X-ray units. Of the estimated 200,000 X-ray machines in use in this country, approximately 100,000 are owned and operated by dentists, exposing about 185 million dental films a year. This averages out to approximately one dental radiograph per person.

Inspection programs of dental X-ray units have been, or are now being, conducted in 45 States. Current plans call for the expansion of the survey program for medical radiographic and fluoroscopic units during fiscal 1963.

The Public Health Service, in its own hospitals and clinics, takes special precautions to protect patients from unnecessary exposure, and operating personnel from all exposure, during the use of X-ray equipment. A continual monitoring system is maintained in our own installations.

In view of the pressing need for greater knowledge of the sources and biological effects of ionizing radiation, particularly at sustained low levels, the Division's research effort has been continually expanded over the past 3 years. The comprehensive program of fundamental and developmental research now underway includes intramural studies at DRH laboratories, extramural projects under contract with universities and medical centers, and independent investigations supported by extramural grants.

The Division started negotiations for radiation research grants in November 1960. Funding of extramural research grants in the field of radiological health was transferred from the National Institutes of Health to the Division of Radiological Health on July 1, 1961. The number and dollar amount of grants has undergone steady expansion: 42 grants, $886,522 in fiscal year 1960; 58 grants, $1,096,964 in fiscal year 1961; and 64 grants, $1,270,440 in fiscal year 1962.

According to the estimates of the National Advisory Committee on Radiation, 1,200 radiological health specialists and 4,000 radiation technicians will be needed by 1970 to staff radiation protection programs of health agencies. To help meet this need, the Division of Radiological Health provides grants to universities for the training of radiation health specialists; for assistance to junior colleges and other institutions for the training of radiation technicians ; for graduate-level traning of PHS commissioned officers and civil service personnel ; and for short-course training for public health personnel in government and industry.

Training grants to universities to improve, expand, or establish radiation health specialist curriculums were made available for the first time in fiscal year 1961 by congressional approval of an initial $500,000. Fifteen universities were selected from applicants requesting almost $2 million-to receive grants for staff, equipment, and student assistance. Fifty-three trainees were supported by the grants program in fiscal year 1961 and 80 in fiscal year 1962. Congressional support of the program was increased to $1 million in fiscal year 1962, and $2 million in fiscal year 1963. Twenty schools were participating in the radiological health specialists training program as of June 30, 1962.

Since September 1961, many thousands of letters and telephone calls have been received by the Division from congressional, press, public, and private sources relating to falout and its health effects. Monthly reporting of surveillance data in Radiological Health Data has been supplemented by frequent issuance of press releases to health authorities and the mass media, particularly with respect to levels of iodine 131 and strontium 90 in market milk.

As part of an effort to increase the reporting of important radiological health research news to the scientific community and the general public, a technical report series has been established which will include findings of specific research projects, literature reviews, and progress or topical reports not only of the Division of Radiological Health but of other environmental health programs of the Public Health Service.

DIVISION OF WATER SUPPLY AND POLLUTION CONTROL

Water pollution control activities of the Public Health Service were carried out under Public Law 410 from 1944 to 1948. In 1948, Public Law 845, the first Federal water pollution control legislation, was passed, and responsibility

for its administration placed in the Public Health Service. The first permanent comprehensive Federal Water Pollution Control Act, Public Law 660, was passed in 1956. The Division of Water Supply and Polution Control was established on July 29, 1959. In 1961, Public Law 660 was strengthened by amendments in Public Law 87-88 and responsibility for its administration in the Secretary of the Department of Health, Education, and Welfare.

Actually, the Public Health Service began studying water pollution and its effects on human health when it investigated waterborne diseases before the turn of the century.

With the introduction of water-carriage disposal systems in the 19th century, dumping raw sewage into lakes and rivers became standard practice. In those early days, it worked well enough. There was plenty of water; the wastes were subject to natural purification processes; and communities were neither so large nor so closely jammed together as they later became.

But as time went on, and industry and population grew, the volume and complexity of wastes grew enormously. They became more and more difficult to deal with in treating water for public consumption.

By the time Public Law 660 was enacted in 1956, the problem had mushroomed to such proportions that the programs this legislation authorized, and directed to be carried out, had become urgent. The law provides a broad base for dealing with both the water resource and the health aspects of water pollution prevention and control. These include development of comprehensive water pollution control programs, enforcement of pollution control, collection of basic data, research, technical training, information ; grants for State and interstate program extension ; grants for research, training, and demonstrations; fellowships; and grants for the construction of waste treatment works.

The growth of industry in the United States has been phenomenal and this growth rate is expected to continue into the foreseeable future. During the period 1900–1950, industry increased its output of goods by 700 percent. During and since World War II, industry has greatly accelerated its productivity and by 1980 is expected to more than double the 1950 figures--more than 14 times production at the turn of the century.

Industry has spread to all parts of the country, and the major trend is the location of industry within metropolitan complexes. On the other hand, industry is helping to create more complexes, since it attracts the labor market and accompanying service groups. There is also a decided trend of industry to move into water-short areas which presents grave water supply problems, both for itself and the supporting communities. When industry locates in a water-short area, or contributes to a water shortage by its demands, it acquires, or shares in, the responsibility for solving the resultant water resource problems.

Probably most significant of our population trends is that toward urban living which will greatly accelerate in the years ahead. Serious water supply problems have resulted from, and will continue to be created by our increasing urbanization. Only a few of our large cities are strategically located with respect to a bountiful supply of fresh water. The problems of maldistribution of population and water will multiply with increasing urbanization. We cannot move the metropolis to the water supply, so we must move the water supply to the metropolis.

Another water need is a reflection of our culture and growing economy. Within a generation, the leisure time and incomes of Americans have increased greatly with the result of an annual outlay for recreation of $10 billion, or more than 8 percent of the gross national product. In 1960 an estimated 30 million Americans participated in sport fishing and hunting. The pleasure boating industry, one of the outstanding growth industries, is now a $2 billion a year business, more than three times its total 10 years ago.

According to “Resources for the Future," outdoor recreation in the next 35 years will increase tenfold. Inevitably, because so much of our outdoor recreation is water oriented, this will mean that recreational use which may result in significant pollution, must coexist with industrial, municipal, and agricultural water uses.

Recreational use of waters—swimming, water skiing, and boating—can cause measurable pollution. The pollution resulting from water-contact sports is principally bacterial or viral. Although epidemiological studies have been made, some of considerable duration and scope, the extent of infections traceable to recreational use of waters is not fully known. It has been demonstrated epidemiologically, however, that such infections can occur. A new and perhaps serious problem of pollution is resulting from the growth of outboard motorboating and water skiing, particularly on lakes and reservoirs. Public Health Service studies are showing significant concentrations in such waters of oil, lead, and combustion products from outboard motor exhausts. The continued increase predicted for motorboating and water skiing indicates that serious attention should be given to the exhaust problem.

Navigation is an old and continuing source of water pollution in estuaries, harbors, and coastal waters. Ship pollution consists of bilge waters, sanitary sewage, garbage, oils, and whatever can be thrown overboard. Few ships afloat today, even those of recent design, have any facilities for the collection, treatment, or disposal of shipboard wastes. Laws and harbor regulations are very difficult to enforce.

The St. Lawrence Seaway has opened the Great Lakes to 90 percent of the world's commercial vessels. With ships from all parts of the world entering and harboring in waters adjacent to public water supply intakes, the chances are greatly enhanced for waterborne disease transmission, and particularly those diseases from other countries which have long been gone from the American scene or never gained a foothold here.

As a result of scientific and technological developments in recent years, new and difficult problems in water supply and pollution control have been created. Synthetic organic chemicals are relatively new pollutants of increasing concern, resulting from new chemical technology. Included in this category are detergents and other household aids, all the new synthetic organic pesticides, synthetic industrial chemicals of a wide variety, and the wastes from their manufacture. The number, variety, and tonnages of these chemicals is increasing rapidly each year. As pollutants, they are characterized by their toxicity, or potential toxicity, to fish and aquatic life and possibly humans, their often extreme stability and persistence in the water environment, and their resistance to removal by conventional water and waste treatment processes.

Perhaps the most important emerging land-drainage problem today involves the tremendous increase in the use of agricultural pesticides and fertilizers. Pesticides include those chemicals designed for use as insecticides, herbicides, fungicides, rodenticides, miticides, nematocides, fumigants, defoliants, plant growth hormones, and soil conditioner. This land-drainage pollution cannot be collected and treated as can be done with most common types of wastes, but must be controlled during the chemical's application.

Production of synthetic pesticides in 1958 amounted to more than 500 million pounds and most of this production was used by U.S. farmers. Each new pesticide introduced on the market is generally more toxic than its predecessor, Some indication of the magnitude of the problem in the immediate years ahead has been given by an official of American Cyanamid Co.'s pesticides-products department who has predicted a tenfold increase in pesticide output in the next 20 years. This could mean, in 1980, pesticide production amounting to more than 5 billion pounds annually.

Most pesticides are not removed by ordinary water and waste treatment processes. Although there are no recorded incidents of acute toxic effects on humans through water supplies, some pesticides have this potential. As the use of these chemicals increases, chronic effects of their long-term ingestion may well be of greater significance than acute toxicity. Analysis of samples taken in connection with several Public Health Service investigations and the national water-quality basic data network program has shown the presence of pesticides in most of our major rivers.

The U.S. farmer is using more and more chemical fertilizers. The growth of fertilizer tonnage and nutrient content is shown by the following figures :

Growth in U.S. fertilizer tonnage and nutrient content

Year 1

Tonnage (in
thousands)

Plant-food

content (percent)

1935
1915
1950
1952.
1954
1956 (preliminary)

6, 345
13, 201
17, 978
22, 052
22. 302
21, 697

18. 2 20.0 22. 0 23.1 25.8 27.5

1 All years after 1935 are fiscal years ending June 30. Source: USDA, Agricultural Research Service.

Fertilizers applied to agricultural lands find their way into natural waters principally during runoff and from soil leachings. Stream pollution from agricultural fertilizers, supplemented by the increasing amounts of nutrients from municipal and industrial wastes, is becoming a water pollution problem that may reach national sigaiticance. A widespread increase in the growth of nuisance organisms and plants stimulated by fertilizers would have serious degrading effects on water quality and use.

Water pollution from radioactive substances may result from the mining and processing of radioactive ores; from the use of refined radioactive materials in power reactors and for industrial, medical, and research purposes; and from fallout following nuclear weapons testing.

Progress, under the provisions of the Federal Water Pollution Control Act, leading toward containment of public health problems resulting from water pollution are illustrated by portions of the fiscal year 1962 Annual Report of The Division of Water Supply and Pollution Control.

1. There was a 22-percent increase over the preceding year in municipal sewage treatment construction stimulated by the construction grants program. Approved were 754 projects to which the Federal grants contributed $65 million and local governments $332 million, a ratio of about 1 to 5.

2. Grant funds to State and interstate agencies, increased from $3 to $5 million per year under the 1961 legislation, have enabled most of the States to expand their water pollution control programs. Stimulated by these program grants, water pollution control budgets of 33 States showed substantial increases in 1962 over 1961.

3. To maintain continuous intelligence on the nature and extent of pollution, the national water quality network of major watercourse sampling stations was enlarged from 91 to 121, with 300 as the ultimate goal.

4. The 3-step Federal enforcement procedure-conference, public hearing, and court action-has been initiated in 20 situations, 5 in fiscal year 1962. Twenty-four States and the District of Columbia have been parties to these actions. They involve some 250 municipalities and about the same number of industries, mostly in large metropolitan complexes. More than 5,000 miles of major water bodies are affected.

5. Research activities include both intramural projects at the Cincinnati center and extramural research projects supported by grants in some 80 universities and other institutions in about 40 States. Together, they seek answers to such problems as wastes origin; more efficient and economical characterization, treatment and disposal of wastes; improved methods in water quality measurement; and the supplementation and conservation of water supplies. Research grants awarded during the year supported 159 projects totaling $2.67 million.

6. Fellowships totaling $98.000 were established to support scientists and engineers at academic institutions in 16 States and 1 foreign country ; 11 demonstration (applied research) grants totaling $300,000 were awarded in 10 States; and 23 grants totaling $693,000 were awarded to institutions in 13 States to establish or expand graduate training programs in the field of water supply and pollution control.

7. Comprehensive water pollution control programs to protect and conserve water quality for all uses for a projected period of 50 years have initiated or expanded in six major river basins. Another in the Arkansas-Red Rivers Basin is nearing completion, with final recommendations for control scheduled to be presented to the Congress in January 1963. In addition, field study projects on problems of national significance have been established with respect to the effects of pesticides on water quality and of recreational uses on water supply reservoirs.

In additon to its legislated programs, the Department has additional responsibilities of providing specialized technical services to other Federal agencies relating to water supply and pullution control. These stem from the Department's membership on the Interagency Committee on Water Resources on U.S. study commissions, its agreements with other Federal agencies, services required by international commissions, and special needs of States and regional jurisdictions.

Technical services under interagency agreements represent a major and expanding activity. Of particular significance in Federal reservoir construction are provisions in the Water Supply Act of 1958 and in the 1961 amendments to the Water Pollution Control Act requiring, respectively, a determination of needs and value of municipal and industrial water supply, and for streamflow regulation for quality control.

Being a national problem, water supply and pollution control generates the need for action at all levels, resulting in a five-way sharing of responsibility. In broad terms, these responsibilities are defined as follows:

1. The State has primary responsibility for water pollution control. It sets the standards in its jurisdiction, and applies its laws and regulations, including intrastate enforcement. It conducts surveys and investigations, collects and analyzes data, provides technical assistance to local governments and industry including training, and does developmental research.

2. Local governments construct and operate municipal sewage treatment works, conduct surveys, provide technical assistance and consultation to industries, and enforce their regulations and ordinances.

3. Industries are responsible for their own pollution. They institute in-plant waste reductions, and construct and operate waste treatment works if separate from municipalities. Industries make alterations in the plant or adopt new processes to reduce or eliminate pollutants. They conduct research to develop or improve waste treatment processes, and to reduce waste pollution.

4. Universities are responsible for conducting research and for training engineering and scientific manpower needed by the other jurisdictions. They also provide technical services and consultation.

5. The Federal Government supple nts and supports the programs of the other four.

Regulation.—Most States prefer to use persuasion in getting municipalities and industries to construct needed waste treatment facilities. However, when reasonable efforts at persuasion have failed, all States should vigorously apply their own enforcement measures, and almost all have workable enforcement laws.

Federal enforcement jurisdiction was extended to all navigable or interstate waters by the 1961 amendments to the Federal Water Pollution Control Act. The Secretary of Health, Education, and Welfare is directed to institute Federal proceedings for the control of pollution of such waters whenever requested by the Governor of any State or a State water pollution control agency, or (with the concurrence of the Governor and of the State agency for the State in which the municipality is situated) the governing body of any municipality, when the pollution is endangering the health or welfare of persons in a State other than that in which the pollution originates (interstate pollution). Whenever pollution is endangering the health or welfare of persons only in the State in which the pollution discharge originates (intrastate pollution), the Secretary shall invoke Federal proceedings when requested to do so by the Governor of that State if the effects of the pollution are sufficient to warrant Federal intervention. Whenever the Secretary has reason to believe that interstate pollution is occurring, he is directed to proceed with Federal enforcement action on his own initiative.

Enforcement actions, both State and Federal, will undoubtedly be invoked more frequently in the future. Supporters of water pollution control are increasing their demands for more aggressive enforcement programs.

While water pollution control measures are sometimes expensive, it is not believed that their cost would be a deciding factor in trade competition resulting from the economic growth of other nations. All developed nations today have water pollution problems much the same as those in the United States, and some are more serious. These nations are also spending large sums of money for water pollution control, as will the emerging nations as they develop.

The Public Health Service provides technical services to two international commissions, the International Joint Commission (United States and Canada) and the International Boundary and Water Commission (United States and Mexico). Increased economic and population growth along our international water will result in increased water pollution. The machinery provided by these two international commissions should, however, provide for effective pollution control measures.

RESEARCH GRANTS

The increasing number and variety of environmental health hazards and prohlems require the ingenious application of every conceivable research methodology, skill, and talent. A number of manpower problems are related to the research effort. Because of the critical shortage of environmental health personnel in the United States, we must do many things with few people. We, therefore, are aiming at the best and brightest students. Naturally such students will be nt

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