a survey competent to see the extent of the injury. Radiation injuries are of the same nature as other human defects so that the problem of detection is one of recognizing a certain incidence of biological effect against a background of normal or natural effects of the same character. This statement of the problem serves to point up the nearly unique nature of the radiation hazard evaluation as a public health measure. 14. Recommendation.-The Federal Radiation Council recognize that the establishment of radiation standards is a somewhat arbitrary matter, that scientific knowledge in the field is far from complete and that the standards reflect the best judgment that experts can make. I would feel that attempts to quantify the balance of risks versus benefits will meet with frustration. Section 7.7 It should be noted that the decisions made on weapons testing in 1954 (the year when U.S. nuclear tests contributed so much nuclear debris to the atmosphere) were scarcely in the democratic tradition. The people were not consulted. Although a group of experts were convened in the summer of 1953 to evaluate the hazards, the record will show that these discussions were held secret long after the 1954 period and that very few of the experts consulted were competent in the biomedical hazards field. Furthermore, at the time very great areas of ignorance existed in technical fields such as meteorology, particle-size physics, fission-product pollution of the food-chain and fission-product uptake in humans. 15. Recommendation.—The Federal Radiation Council should be formally consulted by the Atomic Energy Commission and Department of Defense with respect to its planning for future nuclear tests. The Council should have the power to review the test plans and to disapprove specific tests if competent analysis shows that a significant radiation hazard would exist as a result of the nuclear detonation. Section 7.9 The substitution of "radiation protection guide" (RPG) for "maximum permissible limit" or similar phrases is obviously designed to make the terms less alarming to the public. The original choices of "maximum," "permissible," and "limit" are probably unfortunate, but they are imbedded in the literature and in current practice. I doubt whether revamping the phrase will prove very effective in making the concept more pleasant to people. There is still a limit concept involved. I doubt very much if other nations will adopt the RPG; if they do not, then the different conventions will clash in the literature. Section 7.10 The 0.5 rem dose defined as the allowable dose for an individual on a population basis over a period of 1 year with an average of 5 rem over 30 years needs to be qualified so as to give a greater degree of protection during the most critical periods of the individual's life. 16. Recommendations.—The Federal Radiation Council should subdivide the 5 rem 30-year dose so that the following dose schedule is not exceeded: In utero: 0 rem. Infant: 0.1 total body rem. Youth: 1.0 total body rem (cumulative dose). Adult: 5.0 total body rem (cumulative dose). Section 7.12 See comments under sections 7.3 and 7.5. Section 7.13 This section appears to deal with the radiation problem on an agency-occupational exposure basis. No mode of action is indicated where population exposure is involved, as in the case discussed with relation to Sr contamination of the milk supply. Section 7.17 This section should apply to both the PCG and the RPG as noted in my comment on section 17.10 and recommendation No. 16. Section 17.18 The four recommendations made here, together with the three stipulated in section 7.4, do not, in my opinion, constitute an adequate expression of the research needs of this Nation in the field of radiation standards and protection. Some of the recommendations that I have made should be included in any representative tabulation of research needs in this vital area. 17. Recommendation.-The Federal Radiation Council should assess the research needs for providing the United States with a sound program for radiation protection and prepare a special report detailing these needs. It should indicate those projects which will require long-term research and also those for which special facilities and large appropriations will be required. In conclusion, I repeat that these are preliminary comments directed at section 17. I have not attempted to deal with many other aspects of radiation safety. However, I cannot conclude this commentary without stressing my belief that Federal regulation and control of radiation hazards will be necessary if the problem of reducing human exposure to penetrating radiation is to be solved. To this end, I urged along with Dr. Schubert that the Federal Government enact legislation creating a radiation control service. (Whereupon, at 4:20 p.m., the committee adjourned, to reconvene at 10 a.m., Wednesday, June 1, 1960.) RADIATION PROTECTION CRITERIA AND STANDARDS: THEIR BASIS AND USE WEDNESDAY, JUNE 1, 1960 CONGRESS OF THE UNITED STATES, JOINT COMMITTEE ON ATOMIC ENERGY, Washington, D.C. The subcommittee met, pursuant to recess, at 10 a.m., in room P-63, the Capitol, Hon. Chet Holifield, chairman of the subcommittee, presiding. Present: Representatives Holifield, Price, Van Zandt, and Hosmer. Also present: James T. Ramey, executive director; Carey Brewer, David R. Toll, and Richard T. Lunger, professional staff members; Hal Hollister and James E. Turner, technical consultants. Representative HOLIFIELD. The commitee will be in order. The committee will resume its hearings this morning. The subject matter will be "Concepts of Practical Application." Our first witness this morning is Dr. Richard Chamberlain, University of Pennsylvania. STATEMENT OF RICHARD H. CHAMBERLAIN, M.D.,1 UNIVERSITY OF PENNSYLVANIA Dr. CHAMBERLAIN. Thank you, Mr. Chairman. Representative HOLIFIELD. Dr. Chamberlain, you have been on our steering committee, and we appreciate that. We are pleased to have you before us. Dr. CHAMBERLAIN. I consider it a privilege to appear here today, Mr. Chairman. If I may, I would like to read a statement. Representative HOLIFIELD. Please proceed. Dr. CHAMBERLAIN. I have been asked to discuss some of the features of radiation standards or guides as they bear on the practical applica Home address: 8327 Germantown Ave., Philadelphia, Pa. Date and place of birth: May 25, 1915. Jacksonville, Fla. Marital status: Married; no children. Education: 1930-34, Centre College, Danville, Ky.; A.B., 1934. 1935-39, University of Louisville School of Medicine; M.D., 1939. 1939-40, Louisville City Hospital; rotating internship. 1940-42, fellowship in radiology, hospital of the University of Pennsylvania. Honors and awards: Henry Barret Boyle Prize. Centre College, 1932. Atwood P. Latham Prize, University of Louisville, 1936. Henry Enos Tulley Prize, University of Louisville, 1938. Carman Lecture, Radiological Society of North American, 1952. President, Philadelphia Roentgen Ray Society, 1954-55. Visiting professor, University of Lund, Sweden, 1956. 1st vice president, Radiological Society of North America. 1957. Military service: 1942-46, active service with the U.S. Army; Chief of Radiology Service, 24th Station Hospital and Nichols General Hospital. Certification: American Board of Radiology (Radiology) 1945. Employment: Associated with the University of Pennsylvania School of Medicine since 1940; presently professor of radiology. Other facts Member, National Committee on Radiation Protection, International Commission on Radiological Units, NAS-NRC Committee on Pathologic Effects of Atomic Radiation, National Advisory Council on Radiation of the U.S. Public Health Service 1958 to present, United States Chamber of Commerce Committee on the Public Understanding of Atomic Energy. Technical adviser to Second International Conference on Peaceful Uses of Atomic Energy, 1958. Former member, Committee on Isotope Distribution of AEC. Former chairman, AEC Subcommittee on Human Applications of Radioactive Isotopes. 335 tions in medical practice and have taken the liberty of drawing some inferences and conclusions relating to the larger scope of the discussions here as well. The medical uses of radiation have been so vitally important, and increasingly so, during the past half century, that much of the development of protection concepts has been shaped by the needs and special problems of these uses. It is not surprising that all the answers for the protection problems of the rapidly expanding nuclear age have not been apparent in the standards conceived primarily for these medical applications. The situation has been one, rather, in which "standards" or guides for prudent action have been constantly improved as radiological techniques and knowledge have shown their feasibility and need. It is also true that the development of atomic energy has itself directly complicated the medical uses, but has also had considerable influence on the thinking of the medical profession about appropriate levels of exposure and the control of exposures. In two ways, however, the medical uses of radiation merit special attention in discussions of future control criteria. The first is in regard to a sense of perspective in amounts of radiation which may be used or must be used for sufficiently useful purposes with the concept of value judgments on which such choices are based. The second is the obligation to avoid unwarranted or excessive restrictions which may result in well-intentioned but finally harmful end results, rather than the desired good effect. The practical decisions in medicine which indicate the use of radiation are complex and varied in respect to amount of radiation used, the relative dosages to different parts of the body, the type of diagnostic or therapeutic benefit expected, and the potential seriousness of the disease or condition which is being dealt with. In almost every instance value judgments are required, and it is impossible with present knowledge to be precise in the expression of more than one or two parameters. The range of amounts of radiation needed for various purposes is very broad. These limits extend from as little as one-tenth to onehalf of a milliroentgen, such as may be scattered to the gonads in the performance of a chest X-ray examination with modern techniques, to as much as 50 million milliroentgens which may be administered to at least portions of the thyroid gland in the treatment of thyrotoxicosis. The first is such a small increment relative to natural background levels and their variations as to make it seem of little importance. Yet chest examinations are so widely used and for so many indications that attention to keeping this source of gonadal exposure to as low a figure as is feasible has been seriously pursued, inasmuch as it constitutes more of a population exposure problem than the treatment of the thyroid with radioactive iodine. Chest X-ray examinations are useful for a variety of purposes, ranging from survey examinations for the detection of tuberculosis, in large groups, to the diagnosis of pneumonia or bronchiogenic cancer in a patient with suspicious or full-blown symptoms of such a disease entity. Any of these may literally spell the difference between life and death. Furthermore, the available apparatus, the conditions under which it can be used, the type of projections or study needed, the call for fluoroscopic observation or special film techniques, such as body section exposures, and the need for repeated examinations |