Re: HPS Objective

["David W. Lee" <lee_david_w@lanl.gov>]

At 04:59 PM 07-08-97 -0500, you wrote:
>David --
>
>As one who has had first hand experience with shoe fitting fluoroscopes (I
>cut my health physics teeth on them about 40 years ago), I for one would
>argue that not only was the exposure unecessary, but was also potentially
>harmful, and not necessarily to the feet.  The tubes were typically not
>provided with a shielded housing or enclosure, and exposure rates of tens of
>R/min (that's right, R/min) (and in some cases higher)at the level of the
>gonads of the user were not uncommon.  And, the salesmen were exposed many
>times a day, and might have incurred annual doses in the vicinity of 1 Gy.
>As far as I know, there has never been a followup study of shoe salesmen.
>And, recalling from my youth how many times I used these devices (I used to
>sometimes stop in at a nearby shoe store for fun and games on my way home
>from school), I suspect there was much exposure that was largely ignored.
>
>In any case, as a minimum, given the fact that our knowledge of potential
>low level radiation effects is at best incomplete, prudence would dictate
>that we eliminate such unecessary exposures, even if we cannot say with
>absolute certainty that there will be a discernable detrimental effect
>attributable to them.  This is the essence of ALARA.  And, others could make
>pretty convincing arguments that there might be effects; certainly
>chromosome changes have been observed in populations in areas of high
>natural background, although there does not seem to be a health related
>link.  One could even think of radiation exposure as analagous to cigarette
>smoking --  one or only a few cigarette(s) a day may be OK in terms of
>detectable detrimental effects.  onetheless, prudence (and most physicians I
>dare say) suggests zero.
>
>Just my own opinions for which I undoubtedly will take a lot of flak.
>
>Ron Kathren
>
>    
>	I thank Paul Frame and Ron Kathern for contributing to this discussion
via their respective helpful comments.  I would sincerely welcome the
citation of any professional literature that truly documents the harmful
injuries that Paul describes from shoe-fitting fluoroscopes.  I am
presently unaware of any such citations.  K. Z. Morgan's Chapter 1 of
Morgan & Turner describes exposures from such units and cites literature
citations by the New York City Health Dept and others that recommended
limiting the use of these fluoroscopes, but the limited literature
citations do not appear to document the harmful effects Paul spoke of.

	Paul's story of being the recipient of unnecessary dental x-ray exposure,
I think, should cause HPs to consider what it is we really should be doing.
 Not even Paul alleged that his admittedly "unnecessary" dental x-ray
exposure was "harmful" -- so what is it that we as HPs should be doing --
trying to stamp out "unnecessary" radiation purely because it is
"unnecessary" even though not harmful or focusing our efforts on
potentially harmful sources/levels of radiation exposure?

	For purposes of further discussion, I would propose once again that
underlying the HPS's Objective use of the word "unnecessary" is apparently
the leap of logic "belief" that "unnecessary" is semantically equivalent to
"harmful."  Obviously, I propose that the which is undeniably "unnecessary"
may not necessarily be "harmful."

	I congratulate Paul for his incisive commentary wherein he posits that the
HPS does not appear to be tangibly doing much to meet this stated
Objective.  Hopefully, other RADSAFERS will respond with their own thoughts
in this regard.

Best regards  David
> 
>At 10:45 AM 8/7/97 -0500, David W. Lee wrote:
>>	Speaking strictly for myself, I must say that I fully agree with Bernie's
>>comment.  The word "unnecessary" to me semantically implies that we, as
>>health physicists, should continue to chase after or otherwise mitigate
>>radiation exposures even after such exposures are found to be well below
>>the level of imparting any harmful biological effects.  Semantically, I
>>think the Society's objective, as presently worded, makes an illogical
>>value judgment/conclusion; namely, that if something is "unnecessary," it
>>must a priori be "bad" or "harmful."  I think that a more accurate wording
>>of the HPS's objective would be as follows:
>>
>>		"The objective of the Society is the protection of people and the
>>environment from exposure to potentially harmful levels of radiation."
>>
>>
>>Example to induce further discussion.  One of the most egregious historical
>>examples, from a total radiation exposure standpoint, is the past use of
>>shoe store fluoroscopes.  While I think most HPs would agree that the use
>>of these devices provided no real "value-added" in terms of fitting shoes
>>better, most of us might also have acknowledge that use of these devices
>>did not really result in any biological harm to the feet of those who used
>>the devices.  The radiation exposure was admittedly "unnecessary," but who
>>amongst us wishes to argue that it was "harmful," and if so, if what way?
>>
>>Best regards,  David
>>
>>
>>
>>
>>At 09:19 AM 07-08-97 -0500, you wrote:
>> 
>>         The objective of the Society is the protection of people and 
>> 	the environment from unnecessary exposure to radiation.
>>
>>	--Souldn't "unnecessary" be changed to "harmful", or "unnecessary
>>and potentially harmful"?
>>
>>
>>
>>David W. Lee
>>Los Alamos National Laboratory
>>Radiation Protection Services Group (ESH-12)
>>PO Box 1663, MS K483
>>Los Alamos, NM  87545
>>PH:   (505) 667-8085
>>FAX:  (505) 667-9726
>>lee_david_w@lanl.gov
>>
>>
>
>
>
David W. Lee
Los Alamos National Laboratory
Radiation Protection Services Group (ESH-12)
PO Box 1663, MS K483
Los Alamos, NM  87545
PH:   (505) 667-8085
FAX:  (505) 667-9726
lee_david_w@lanl.gov