It was 30 years after the discovery of x-rays before world leaders in the fairly new medical specialty decided that something had to be done to define x-ray units and make recommendations for their safe usage. The first significant effort was made at the first International Congress of Radiology in 1925 in London, England. This led at the next international meeting in 1928 to the establishment of two international commissions—one to define radiation units and the other to recommend safe practices.
It was only a matter of weeks in 1896 before physicists and doctors who were applying x-rays to medical diagnosis realized that chronic exposure to x-rays emitted in all directions by unshielded vacuum tubes exposed the doctor and his helpers and caused harmful changes, skin lesions, cancers, and, for some, early deaths. There were no tools to measure the x-ray exposures and no standards for dose recommendations. In 1913, William D. Coolidge, a physicist at the General Electric Company, devised a new “hot cathode ray” tube with a metal protective shell and an adjustable aperture for a controllable x-ray beam to emerge in a single direction. But the need for measurements and safety precautions remained unanswered for another decade.
After the 1925 international meeting, American radiologists asked the US Department of Commerce for help in measuring x-rays. Their request was sent to the Bureau of Standards and assigned to a newly employed physicist, Lauriston S. Taylor. He was sent to the 1928 congress in Stockholm, Sweden, where radiologists and scientists from several countries agreed to organize two working committees to address the matters of x-ray units and radiation protection. Lauriston Taylor volunteered to serve on both groups. A year later, he organized an American working group, now known at the National Council for Radiation Protection and Measurements.
At the 1928 meeting in Sweden, the expert committee drafted the first set of recommendations for x-ray and radium use safety. The draft was circulated among national societies and formally adopted at the 1931 international congress in Paris, France. The approved document contained 43 international recommendations. Most of the points are now contained in more sophisticated publications from the International Commission on Radiation Units and Measurements and the International Commission on Radiologic Protection, as well as the American NCRP.
The first recommendations dealt with working hours: no more than 7 hours per day, 5 days per week, with 4 weeks of vacation yearly, and semiannual physical and blood assessments.
The second batch defined x-ray department conditions: none below ground level, plenty of windows for sunshine and fresh air, reasonable working temperature, and well laid-out exam rooms with x-ray generating devices separate from the x-ray tubes.
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