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Radiation in Medicine: A Need for Regulatory Reform
The states thus have by far the greatest share of regulatory responsibility for overseeing medical uses of radiation. The consensus view is that the smaller, NRC-regulated portion of the field—which concerns uses of byproduct materials—is more stringently regulated than the state-regulated portions, which concern uses of NARM and machine-produced radiation. This view is discussed in later sections of the chapter. Table 3.1 lists the states and indicates the type of regulatory programs in place in each. The unofficial Conference of Radiation Control Program Directors (CRCPD) data were collected for the Profile of State and Local Radiation Control Programs over a nine-year time span. The data are updated sporadically and do not necessarily reflect the current status of every state, because they have not been updated since 1993. Because no record of which changes were made in the 1993 data update exists, it is impossible to provide a date for when the information was obtained. In the ''legislation" column, "mandated" indicates those states compelled to adopt regulations and implement programs (although this process can take a fair amount of time); "authorized" indicates that a state is authorized to adopt regulations and implement a program but is not required to do so. The "date" column refers to the date of the current statute, whereas the "original date" column indicates the date when the state first created a statute that addressed licensing and registration of NARM.
Although state laws, regulations, and administrative practices vary, states can and do achieve a level of uniformity in many areas through cooperative, voluntary, and informal arrangements. The most noteworthy example of such arrangements in the regulation of ionizing radiation is the publication called Suggested State Regulations for Control of Radiation (SSRCR), which forms the basis for most state and local radiation protection programs. The SSRCR is a group of voluntary suggested guidelines prepared in the form of draft regulatory language available for state adoption. The SSRCR was first issued in 1962 by the Council of State Governments, with advice and assistance from the AEC and the U.S. Public Health Service. It has been regularly revised and updated to reflect changes in standards and technology and to incorporate changes in mandatory and voluntary federal regulations.
Today, these model regulations are prepared and published by the CRCPD. The CRCPD, established in 1968, is a not-for-profit network of state and local government radiation regulators. Although it has no independent regulatory authority, it is actively involved in information sharing and technical assistance activities. The CRCPD membership represents both NRC Agreement States and states directly regulated by the NRC; thus, it participates in implementing and providing feedback on NRC regulations. It was also involved, with the FDA and the American College of Radiology, in developing the MQSA and establishing the Nationwide Evaluation of X-Ray Trends program, which collects information and produces recommendations for planning and evaluating x-ray and computed tomography scan control programs.