all of the people who will be involved in environmental health? Aren't there needs for less ambitious programs to train assistants?

Mr. POHLIT. I am so glad you asked that question because just yesterday I had the privilege of meeting with the leadership at Metropolitan State College in downtown Denver, and we were discussing 2-year programs which they are incorporating right now.

Let me just joint out that next week, the 27th, 28th, and 29th of May, we will be meeting in Atlanta, Ga., with some of our top people all over the Nation to incorporate this program. So we are looking for the aid, the technician, lay people and what not.

Although we say we are a professional organization, we are bringing the public into this organization to make it worth while, instead of having tunnel vision as you see in so many professional groups.

Within the next week we will have 2,500 letters going out to all the medical doctors in the State of Colorado inviting them to be a part of this.

Because as you know most of them are in curative medicine and not preventive medicine. We have these all over the Nation, and we go in and try to cure them of whatever they may be coming down with.

Senator DOMINICK. Thank you. Then you are going ahead on programing to try to get aids and assistants in?

Mr. POHLIT. Yes, it is well underway. I am working with all the college systems.

Senator DOMINICK. I understand from my brief conversation with you before your formal testimony that although Congress had indicated that environmental health personnel were eligible under the bills that we have before us, the bills have not in fact been so interpreted down town.

In that correct?

Mr. POHLIT. This is so true, Senator Dominick. I have had a very rough time promoting this area. In fact our lipservice that we normally get, and I hate to put it this way, but I don't know of any better words, is that, "Gee, we just have so many, many other people to think about and so we can't do you much good."

In fact, you should even see, for example, brochures, or motion pictures, on any of these things that I am mentioning as far as audiovisual thinking.

We are never part of that, and it is nauseating to see this happening in the Federal Government.

Senator DOMINICK. In our education acts we have had provisions to provide technical assistance in education, which included a lot of audiovisual equipment. We had testimony before the education subcommittee indicating that so much money was going into this area that education was not able to use the money profitably.

Tell me, is technical equipment being used in connection with environmental health?

Mr. POHLIT. It has not been up to now.

Senator DOMINICK. Is that the fault of the college administrator? Mr. POHLIT. It could be. But let me point out that at 8 o'clock I met with Roger Egeberg, and we had quite a conversation, and he mentioned that he is going to work out and see if he can't get an

appointment with myself and Dr. Allen, who is Commissioner of Education, to see if we can't work out something here.

Senator DOMINICK. I think that would be helpful. A lot of these things are between Health and Education and an awfully lot of the people get bogged down on one road, when if they took the other branch of it they might find more help available.

Mr. POHLIT. I would like to make a comment along the lines you are talking about, Senator, and that is that our key is education. In fact it makes me again laugh at times to see such large appropriations going into air pollution or solid wastes, and really it is not taking care of the problem, because what we need is skilled people.

In fact, it is like something you are familiar with, and that is, I happen to be a board member of the Metropolitan Sewage Disposal District in Denver, and have been for 10 years.

One of the directors of the State agency applied for the job as manager of this unit. I said "If you had done your job in the first. place, we would not have had need for this kind of unit here."

Then so it goes throughout the Nation. We need skilled people, and you can't get this through the academic programs we have in the States today.

The CHAIRMAN. That illustrates an old legislative adage, that it was easier to get money for concrete than it was for people. Senator DOMINICK. It still is.

Thank you very much.

The CHAIRMAN. Thank you for this very able presentation and contribution here.

The CHAIRMAN. The next witness is Mr. Richard Olden, chairman of the committee on legislation of the American Society of Radiologic Technologists of Johns Hopkins Hospital, Baltimore, Md. Do you have somebody with you?

Mr. OLDEN. The gentleman on my left is Mr. George Mead, who is our legislative representative in Washington for the national society. The CHAIRMAN. Proceed in your own way, Mr. Olden.

STATEMENT OF RICHARD OLDEN, CHAIRMAN, COMMITTEE ON LEGISLATION, THE AMERICAN SOCIETY OF RADIOLOGIC TECHNOLOGISTS, JOHNS HOPKINS HOSPITAL, BALTIMORE, MD., ACCOMPANIED BY GEORGE G. MEAD, LEGISLATIVE REPRESENTATIVE Mr. OLDEN. As you know my name is Richard Olden. I am the administrator and director of the school of radiologic technology of the department of radiology, the Johns Hopkins Hospital.

I am here this morning on behalf of the American Society of Radiologic Technologists, a professional society of approximately 11,000 members.

I am chairman of the society's committee on legislation and a member of the board of directors. I am also a past president of the society, having held that office in 1953-54.

The U.S. Public Health Service has defined radiologic technology as the science and art of applying ionizing radiation to human beings for diagnostic or therapeutic purposes.

Persons employed in this profession practice radiologic technology under the direct supervision of a licensed practitioner of the healing arts, usually a radiologist.

Within the field of radiologic technology there are several sub fields or specialties as follows: X-ray technology, radiatiton therapy technology, and nuclear medicine technology.

Each of these subfields requires special training in addition to, or an area of concentration within a basic 2 year radiologic technology curriculum.

The membership of the American Society of Radiologic Technologists is comprised of registered radiologic technologists. This means that each member is registered by the American Registry of Radiologic Technologists-a technologist certification board, founded and jointly sponsored by the American Society of Radiologic Technologists and the American College of Radiology.

The American Society of Radiologic Technologists is not only supportive of measures designed to improve education and training in its area of allied health, but is directly involved through its representatives serving on a joint review committee of the council on medical education of the Armed Medical Association in the process and training program inspection.

In addition, like most professional societies, the American Society of Radiologic Technologists is deeply involved in efforts to upgrade educational quality and enhance educational opportunity for prospective radiologic technologists.

Mr. Chairman, I am here this morning to reiterate the position of the society in support of the Allied Health Professions Assistance Act, and to declare our unwavering enthusiasm for the proposed amendments to the act which are currently before this subcommittee.

It is a well-known fact that a shortage of allied health personnel exists in our country and that in some areas this shortage has reached the crisis point in terms for providing adequate health care to large segments of our population.

This situation is unfortunately no less true in radiologic technology than in other areas of allied health. Perhaps it is even more fortunate that we cannot point to radiologic technology as an exception to this rule because we know that a dearth of qualified personnel in allied health is often filled by unqualified personnel and ionizing radiation in the hands of unqualified personnel may become an extremely lethal substance.

We know the direct causal relationship between ionizing radiation and severe somatic damage, such as cancers and leukemia. We know of the even more severe prospect of ionizing radiation causing genetic damage to humans which may not become evident for several generations of progeny until damage turns up as serious physical and mental deficiencies.

Therefore, Mr. Chairman, we feel the public has a much greater stake in elimination of unqualified users of ionizing radiation in medicine than it does in many other problem areas within our health care system.

However, Mr. Chairman, I would be remiss if I left the committee with the impression that the shortage of qualified radiologic technol

ogists may be alleviated by Federal aid to education or, indeed, by the resources of our educational system.

Simultaneously we will have to overcome other obstacles which contribute to this shortage. I would like to briefly describe what we consider to be our two greatest companion problems to educational improvement.

The rate of increased use of radiation in medicine in recent years is not unlike the advent of the automobile. Once they caught on, X-ray machines appeared everywhere and just as the roadways of our Nation were not ready for automobile traffic, medicine is still trying to catch up with and control the use of radiation-producing devices.

There are approximately 200,000 medical and dental X-ray machines currently in use, and the Public Health Service estimates that approximately one-half of our population undergoes diagnostic X-ray processes each year.

The operation of these machines is attributed principally to approximately 117,000 individuals practicing X-ray technology.

Only 60,000 persons so engaged are registered radiologic technologists, and of registered technologists it is estimated that only 40,000 are active. In other words, only about 40 percent of active technologists are registered.

It may be seen, therefore, that a shortage of qualified personnel is due in large part to the proliferation of equipment which has become available to the healing arts during recent years. However, the shortage of radiologic technologists is also due in part to the rather high educational demands placed upon prospective technologists-at least 2 years of didactic and clinical training after high school graduation-and the rather low return offered in terms of job opportunity— a position in a hospital or clinic which initially pays $500 per month on a national average.

Thus we must take steps to improve the economic incentives for entering the field of radiologic technology.

This situation is compounded by the fact that employment in the field is not dependent upon completion of all, or any training in radiologic technology.

I am referring to the approximately 57,000 persons employed in radiologic technology who have not demonstrated qualifications to be so employed.

The American people have never had a look at this group, Mr. Chairman, either statistically or in terms of average educational and experience profile.

However I am pleased or perhaps chagrined to be able to offer as an example a very recent study conducted by the North Dakota Department of Public Health which points to the rather discouraging conditions in one of our less populous States. I offer the following extracts from the study:

An average of 8,529 patients is radiographed per week in the healing arts specialties in North Dakota (current population. 625,000) for a total of 443,508 patients radiographed per year. Hospitals and multiple specialty clinics account for 81 percent of the radiographs taken.

An average of 881 patients receives a fluoroscopic examination each week for a total of 45,812 examinations per year.

Of this fluoroscopic workload, 88 percent are conducted in hospitals and multiple speciality clinics.

Major deficiencies resulting in an unncessary genetically significant dose were found to exist in facilities that expose 195,676 persons annually.

Forty-nine percent of the individuals operating X-ray equipment in North Dakota are not registered wth the American Registry of Radiologic Technologists.

Of nonregistered technicians, 95 percent are employed by hospitals and multiple specialty clinics.

Of nonregistered technicians, 76 percent had less than a year of X-ray training and 74 percent indicated that aspects of X-ray protection were not included in their training.

The proceedings of the national conference on X-ray technician training which was sponsored by the Bureau of Radiological Health of the Public Health Service in September 1966 at College Park, Md., referred numerous times to the text of the report of the need for a profile study of ionizing radiation workers similar to the North Dakota study.

It is suggested and highly recommended that it would be most valuable to all concerned if a similar study could be sponsored and conducted with Federal financial support.

It may be seen, Mr. Chairman, the our concern for the education and employment of radiologic technologists involves not only a supply/demand consideration but much more importantly a concern for the safety and well-being of current and future generations of Americans who may suffer due to uniqualified operation of medical X-ray equipment. This is why the American Society of Radiologic Technologists is dedicated, above all else, to the formulation of national minimum standards for training and employing operators of medical X-ray equipment.

Our enthusiasm for the proposed extension of and amendments to the Allied Health Professions Act is not directed to any one of the three bills before the committee. I understand these to be slighly different in approach to or level of authorization and to have minor differences in approach to improvements in the substantive provisions of the act.

With regard to funding I am sure the committee will understand when I report a recognized need for more funds to develop and improve education and training in radiologic technology.

With regard to the substantive provisions I am sure the committee will benefit more from the testimony of witnesses who have had direct experience with the workability of the current provisions of the act. However, our enthusiasm does center on one particular proposal which I understand to be common to each of the three bills.

The prospect of eliminating the limitation of grant eligibility to junior colleges, colleges, and universities is most encouraging to radiologic technology. Please do not interpret this to mean that we prefer radiologic technologists to be trained elsewhere than on college and university campuses.