level, whereas the average concentration in the sixth mine is slightly above three times the working level. In the case of three mines in this group, operations have been temporarily suspended in a total of five working places pending the installation of some additional ventilation.

By comparison, we reported in February that sampling disclosed only 3 mines with radon daughter concentrations below the working level, 1 with an average concentration of between 1 and 3 times, 7 with average concentration of 3 to 10 times, and 6 in excess of 10 times the working level.

The results of the Commission's studies in attempting to bring AEC's leased mines into compliance point up the general problems involved in reducing radiation hazards in uranium mines. It is essential that there be continuing surveillance both by management and others having jurisdiction over mines to insure that adequate ventilation is maintained at all working places at all times.

Sincerely yours,

A. R. LUEDECKE, General Manager.

Representative HOLIFIELD. Our final witness for the morning will be Dr. Francis Weber, Chief of the Division of Radiological Health of the U.S. Public Health Service.

STATEMENT OF FRANCIS J. WEBER, M.D.,1 CHIEF, DIVISION OF RADIOLOGICAL HEALTH, BUREAU OF STATE SERVICES, PUBLIC HEALTH SERVICE, U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Dr. WEBER. I appreciate the privilege, Mr. Chairman, of appearing here.

The CHAIRMAN. You might start off by telling us what is the Public Health Service responsibility in the mining area.

Dr. WEBER. As I understand it, Mr. Holifield, our responsibility would not be a direct one in terms of inspection or correcting conditions. We would work through the States.

Mr. HOLIFIELD. How about the contamination of streams by the waste material from mines?

Dr. WEBER. If this is an instance of interstate streams contamination, then we do have a responsibility. As a matter of fact, this is described in the report.

Mr. HOLIFIELD. From the standpoint of conditions within a State, intrastate, you actually would have no authority at all except in an advisory way, working through the State health groups?

Dr. WEBER. We have an indirect authority in our law in that the law enjoins the Surgeon General to assist the States in the enforcement of their regulations governing health hazards within the State. Mr. HOLIFIELD. Do you have any peculiar authority in mines that are owned by the AEC?

Dr. WEBER. We do not.

Mr. HOLIFIELD. As differentiated from a privately owned mine. Dr. WEBER. No, sir; we do not. We work with the AEC, however, on a consultative basis.

Mr. HOLIFIELD. You may proceed with your statement.

Dr. WEBER. Thank you, Mr. Chairman.

This is a summary of the main report, which I would appreciate being accepted for the record.

1 Biography of Dr. Francis J. Weber appears with his earlier testimony on p. 158.

Mr. HOLIFIELD. It will be accepted.

Dr. WEBER. It contains the details that the summary covers. (The prepared statement of Dr. Francis J. Weber follows:)

CONCEPTS OF PRACTICAL APPLICATION OF RADIATION PROTECTION CRITERIA AND STANDARDS

By Francis J. Weber, M.D., Chief, Division of Radiological Health, Bureau of State Services, Public Health Service, U.S. Department of Health, Education, and Welfare

1. INTRODUCTION

Proper practices in radiation protection constitute a subject equal in complexity and importance to the other topics already considered during these hearings. All radiation is considered hazardous, and the variety of individual sources of radiation dictates different modes of operation with respect to each type of source. Problems engendered by fallout require one type of procedure; radioactive wastes a different one; medical X-ray management still another.

Health agencies, in view of their responsibilities for overall health protection and for promoting optimum health in the general population, have an interest in such matters. As a prelude to applying standards in practice, a health agency will want to know what the general population exposure is, or has been, and the circumstances of it. In making these determinations, certain techniques are employed, and findings are judged in relation to recognized radiation protection guides. Thus, data derived from measurements of water, air, milk, and of other factors influencing dietary intake, are evaluated to determine whether the exposure experienced meets standard criteria. At the same time, some attempts are made, in the case of internally absorbed radioactive materials to estimate body burden, as well as other types of estimates to assess possible cumulative effects from external sources like the X-ray. This furnishes an index to population status as related to radiation, and renders possible application of statistical techniques to provide rough estimates of probable somatic and genetic effects in the population at risk.

Although public health interest in radiation exposure centers in the population itself and the more immediate circumstances of the exposure, this interest is broad enough to extend to the management of sources not under direct public health control. This interest often takes the form of technical assistance and consultation, as well as requests for information respecting the type of public health problem which might arise from such sources. The treatment of radioactive wastes and the various means of its disposal provide examples of this sort.

In all such efforts, the goal is the elimination of unnecessary exposures, while insuring that interference with beneficial uses be kept to a minimum. Certain approved techniques are employed, and these techniques are in turn governed by standards of procedure, to the practice of which they must conform.

We might at this point examine some of the public health areas of ongoing activities in which radiation standards are applied.

II. RADIATION PROTECTION TECHNIQUES APPLIED WITHIN THE ORGANIZED PUBLIC HEALTH COMPLEX

The State health agencies, and their local counterparts, by statutory requirements, in fact or in potential, represent the principal mechanisms for applying radiation protection standards to the benefit of their communities and thus of the population as a whole.

Those State agencies generally found to be supporting radiological health activities are the health boards, councils, or departments; the labor commissions or departments; and to a lesser degree the more specialized agencies which may have been formed to carry out specific programs, such as control of food and drugs, water or air pollution, or others. In most States, a close relationship exists between these various agencies.

State radiological health activities emphasize one or more of these four major aspects:

1. Consultation, including public information, technical consultation and factfinding.

2. Regulation, involving interpretation of general health legislation, reference to nationally recommended standards, and specific radiation regulations and codes.

3. Prevention, aimed at reducing or eliminating unnecessary radiation exposure, usually accompanied by direct or indirect references to specific regulations or codes, based on national guides covering recommended practices, regulations, or codes.

4. Training activities which include orientation and indoctrination in the principles of radiation-protection standardization processes and guides.

The Public Health Service, through its consultative, research, training, and technical assistance relationships with the States, has opportunities to influence all four of the major aspects of State radiological health programs listed above.

To date, inventories have been completed for 40 States, and 3 are in the process of being inventoried.

Although 21 States have specific enabling legislation for radiological health activities, we do not know whether authority exists in these States for an agreement between the Governor and the Atomic Energy Commission in this field. In many of the 29 States which lack specific statutory authority for radiological health activities, the health agency and other interested State agencies indicate that they possess sufficient authority for the implementation of radiological health programs under existing general public health or industrial health laws. Again, in these States we lack information about the authority for the Governor to enter into an agreement with the Atomic Energy Commission.

Thirteen States have regulations for radiological health; 3 have limited regulations; 11 have proposed or pending regulations; and the remainder have no radiation codes or regulations. Lacking a revision of 10 CFR 20 and/or model regulations promulgated by the AEC, we are unable to estimate the compatibility of the regulations at the State and Federal levels.

Twenty-three States require registration of radiation sources and 11 have proposed on pending registration requirements.

Twenty-six have a State atomic energy coordinator or committee; two more propose such.

Fifteen have an advisory committee on radiation to the State health agency, and another six are actively working toward it.

In each case described above, State administrative or legislative action has established a basis for radiological health activities to be conducted by the principal State health agencies. The traditional relationship long established between the Public Health Service and the State health agencies has enabled the Service to provide consultation to the States on the technical standards from which the State legislative acts, regulations, codes, and rules are derived. The principal sources of guidance employed in this phase of the program have been the model radiation acts proposed by the American Public Health Association, the National Committee on Radiation Protection and Measurements (NBS Handbook 61) and the Council of State Governments, the radiation regulations suggested by the National Committee on Radiation Protection, and those adopted by the Atomic Energy Commission (CFR title 10, pt. 20). Each of the above makes use of the basic criteria derived by the ICRP and nationally recommended by the NCRP.

Additional State guidance has been provided by recent recommendations, statements, and resolutions of such professional bodies as the American College of Radiology, the American College of Oral Roentgenology, the National Tuberculosis Association, the American Trudeau Society, the Association of State and Territorial Health Officers, the World Health Organization, and others with an interest in radiological health.

The Public Health Service will continue to have opportunities to influence the development, as well as the practical application, of standards and criteria utilized by the States for the basis of their radiation-control activities. For example, the Service has membership on the NCRP; has assisted the American College of Radiology in developing statements incorporated in the recent professional film, "Radiation: The Physician and Patient"; maintains a close working relationship with the Association of State and Territorial Health Officers and the World Health Organization; and worked with the American Trudeau Society and the National Tuberculosis Association in making an interpretative statement respecting the radiological safety aspects of mass chest X-ray studies.

The Service is also represented on the Nuclear Standards Board of the American Standards Association, and has a consultative relationship with the AEC in regard to the Commission's proposed criteria for implementing Public Law 86-373.

Direct technical consultation, assistance, and program guidance, including that relating to national radiation guides, is provided to State health agencies by the Public Health Service through its eight regional offices. In order to provide expert radiological health consultation, the Division of Radiological Health has assigned specially trained officers to four of the regional offices, and hopes to staff the remaining four within the next fiscal year. Supplemental training has been given to personnel in all regional offices.

An effective mechanism for assistance in the development of radiological health programs within State health agencies is the detail of specially trained Public Health Service personnel to participate directly in the development of these programs. The loaned individual not only assists in the carrying out of the program during his assignment but also help train State personnel who will carry on the program at the termination of the Public Health Service officer's assignment. In many instances, the presence of the Public Health Service officer permits the State to release one of its own personnel for graduate training in radiological health. At the present time, trained Public Health Service officers are assigned to the States of Oregon, Texas, Minnesota, Michigan, California, Georgia, Florida, Massachusetts, New Jersey, New York, and Pennsylvania.

Consultation on specific problems is another mechanism for State assistance. The daily working relationships between State health staffs and the regional offices permit this consultation to be carried out in the most effective way. This frequently serves to stimulate and promote the earlier appearance of comprehensive programs and services within the State. The following example illustrates this:

The Dade County Medical Society (Miami) requested the Florida State Board of Health to survey all the medical X-ray units in use in that county. As a result of being asked for help to do this, the Public Health Service assigned two trained specialists to help initiate the survey, to develop the procedures and methods of operation, and to provide on-the-job training to the State health department's personnel who would continue the survey. The results of the Florida program will be made available this month at the annual meeting of the American Medical Association in Miami Beach. Similar technical assistance is being conducted on a demonstration basis, in Prince Georges County, Md., and in North Dakota State.

The latter project is particularly important. This involves a corrective evaluation of significant features of dental X-ray equipment which contribute to unnecessary radiation exposure to patient, dentist, and technician. Good results are being obtained through the use of an inexpensive film packet, handled through ordinary mail services. The project is being carried out with the cooperation and participation of the State dental society and the State health department. The criteria for this type of corrective evaluation is derived from the recommendations of the NCRP found in NBS Handbook 60, and those of the American College of Oral Roentgenology.

Other Public Health Service assistance stems from its direct statutory interest in the pollution of interstate streams. Over the past 2 years, a study of the Animas River, conducted jointly with the Atomic Energy Commission and the State health departments of Colorado, Arizona, and New Mexico, resulted in orders to operators of uranium mills which are expected to reduce significantly the radium and other pollution of the Animas River, a source of both potable and irrigation water. A similar jointly cooperative study is planned for the Clinch River in Tennessee.

A principal problem in conducting programs of this type is that the State health agencies, with a few questions, are now only on the threshold of developing competent laboratory facilities and interpretive procedures in the field of radiological health.

An additional series of actions by the Public Health Service has been taken to provide the information, derived in the laboratory, upon which the Service and the State health agencies act, in relation to existing standards.

The Service hopes that within the next few years there will come into existence a comprehensive radiological health program in each State. Pending development of adequate State laboratory services, the Public Health Service must con

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tinue to fill the gap created by the general population need. This year, the Service has placed two laboratories in operation. In addition to that at the Robert A. Taft Sanitary Engineering Center, at Las Vegas, Nev., and Montgomery, Ala. Added to Cincinnati, these represent a considerable increase in laboratory resources available to both the States and the Public Health Service. A third branch laboratory is planned for early in fiscal year 1961, with a program designed to make basic contributions to (1) the better management of X-ray and (2) the development of special instruments like the portable whole body counter for application in both the program operations as well as the research field. In addition, an ongoing program of background studies will have been initiated and intensified. Experience will also have been gained in the program of collation and analysis of data on all sources, with resulting guidelines affecting further work; and hopefully, the Service and the States will, by 1961, be making more significant contributions to the formulation and interpretation of standards.

III. THE PRACTICAL APPLICATIONS OF RADIATION PROTECTION STANDARDS IN THE FIELDS OF X-RAY DIAGNOSIS AND THERAPY

Since fairly specific details are provided in "Selected Materials on Radiation Protection Criteria and Standards: Their Basis and Use" (pp. 854 to 912, inclusive), only some general comments will be made at this point. First of all, this area differs from the environmental because it involves individual applications of sources such as the X-ray and radioisotopes by practitioners of the healing arts. Therefore, protection would seem to be mainly in the realm of preventive medicine and involve individual decisions by the practitioner and his patients. This emphasizes the importance of professional education, not only for the diagnostic and therapeutic purposes to be served but also in an ap preciation of, and more exact knowledge of, potential hazards attending the use of these sources.

It is believed that the present exposure guides are adequate, if recommended practices based on them are followed. Such techniques are remarkably effective and do not interfere with the health benefits to be achieved. A wellunderstood body of safety procedures now exists, a result of practical experience, over the years, with the effects of overdosage.

This body of knowledge developed concurrently with X-ray use. It is interesting to speculate as to whether the X-ray would have been used at all during the early period if the first practitioners knew what is known today. At that time, an exposure of 30 minutes might be required to secure interpretable roentgenograms of internal structures like the kidney, all of this without available protective techniques. It is, therefore, a tribute to the profession, both in the healing arts and the physical sciences, that efficient safety procedures are now available to enable remarkable reductions, even with today's much higher powered equipment.

There are still some questions, however, respecting the effects of exposure in the very low range. As the report submitted for these hearings indicates, this problem is being followed in a number of studies, with emphasis on those involving irradiation of the child in utero and other children in the young age groups. In this way, more adequate information can be developed and put to use during the process of formulating radiation protection guides.

IV. THE SIGNIFICANCE OF SOME RESEARCH EFFORTS FOR PRACTICAL APPLICATIONS Further improvement in the practical applications of standards depends on additions to knowledge through research efforts in the human population, including a study of associated factors. In lending its assistance in this area, the Division of Radiological Health of the Public Health Service, during the past year, has initiated, among others, the following studies:

A. Epidemiological study of body burden of radioisotopes in people of the San Juan Basin area

One of the principal problems of standardization in the radiation-protection field is making possible more accurate estimates of cumulative body burdens of radioactive materials, especially in terms of somatic effects. The basis for present estimates is quite slender, with only a few dozen cases providing the material for official guidelines respecting tolerances in the skeletal system. This has required a method of procedure which still leaves some important questions unsettled: