benefits to the health of the population and the costs of regulation to society. The number of lethal or highly morbid adverse events appears to be small, at least as can be determined from the available information. The findings of the committee point to the need for improved databases on the actual incidence of adverse events and severe misadministrations.

The apparent low incidence of adverse events suggests that the stringent NRC regulation of the practice of medicine may not be warranted. It is clear, however, that all uses of ionizing radiation call for some level of regulation and that this regulation needs to be made more consistent and coordinated. To date the federal role has been uneven and divided; much of the current supervision of educational requirements in the use of ionizing radiation, other than the minority of incidents in which byproduct material is used in Non-Agreement States, falls to the states themselves. The chapters that follow give in detail the basis for these introductory observations and make recommendations as to ways in which the regulation of ionizing radiation in medicine may be made more uniform and more responsive to the actual risks involved.

REFERENCES

Chilk, S.J. NRC Memorandum for James M. Taylor, Subject CHILK, Comis-92-026-Review of the Regulation of the Medical Use of Byproduct Material, December 21, 1992.


GAO (General Accounting Office). Nuclear Health and Safety: Consensus on Acceptable Radiation Risk to the Public Is Lacking. RED-94-190. Washington, DC: General Accounting Office, 1994.


NRC (U.S. Nuclear Regulatory Commission). Loss of an Iridium-1992 Source and Therapy Misadministration at Indiana Regional Cancer Center, Indiana, Pennsylvania, on November 16, 1992. NUREG 1480. Washington, DC: Nuclear Regulatory Commission, 1993.


Selin, I. Statement Submitted by Chairman of the NRC to Committee on Governmental Affairs, U.S. Senate, 1993.



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