sources. The majority believes that regulation of all ionizing radiation used in medicine should be uniform. However, this is the extent of the agreement among respondents. The proposals for how uniform regulation could be achieved revealed a spectrum of ideas.

Three respondents said that a new federal agency should be created (one said a new agency within DHHS and one of the three said a new one or the FDA). Three respondents stated that the NRC should retain jurisdiction, and one stated that the NRC should expand its authority to include discrete NARM (naturally occurring and accelerator-produced materials) and potentially accelerators. Two indicated that they preferred the FDA. Four stated there should be a single agency, but did not identify an existing one or state whether there should be a new one. One respondent said responsibility should be split between the FDA and the NRC, with the FDA regulating electronic product radiation and the NRC regulating all radioactive material used in medicine. Four indicated that the states should assume responsibility, and one of the four said the states should be subject to a national set of performance standards.

Two respondents said the NRC should not be the agency regulating ionizing radiation; one said the EPA should not have the responsibility; and one said that FDA should not be the lead agency. Two respondents indicated that a single agency is not needed, and one said that if a need is perceived for a lead agency it should not be the NRC. Finally, one proposed to coordinate all radiation regulations, including NRC regulations, within the Executive Branch (e.g., in the National Science and Technology Council via CIRRPC). Another organization proposed to reestablish the Federal Radiation Council.

Thus, it is generally believed that all of ionizing radiation should be regulated by a single agency. "[There are] too many instances in which reactor-generated materials are more stringently regulated than NARM materials" (NEMA). States with adequate resources would have the right to implement and enforce combined regulations under provisions similar to the Agreement State provisions of the NRC. Licensing, inspection and enforcement would come within the authority of these Agreement States, but they would have to adhere more closely to regulations promulgated by the new agency. The new/federal agency would still carry oversight responsibility (NEMA).

There was some concern that creating a single agency to address all of ionizing radiation may not be the appropriate solution. For instance, Syncor did not believe that providing the NRC with authority to regulate the medical uses of other forms of ionizing radiation will necessarily improve the quality of regulation, or better effectuate the goal of regulation.

"Relative harm to the public should be measured prior to establishing regulations. Existing voluntary efforts should be analyzed and a determination made as to the cost effectiveness of adding further regulations. Fiscal analyses of where the public's money would be best spent to protect the public should be made prior to the adoption of future regulations" (ACR).

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