Credentialing of diagnostic x-ray technologists: a question of public health impact

This paper presents estimates of the number of diagnostic x-ray examinations performed in the United States, the population dose delivered, the percentage of that dose contributed by credentialed and noncredentialed operators, and one measure of performance: collimation of the x-ray beam. An estimated 82 per cent of medical x-ray examinations are performed by voluntarily certified (ARRT or ARCRT) operators. These procedures contribute 90 per cent of the radiation dose to the population. Data from the Nationwide Evaluation of X-Ray Trends (NEXT) program indicate that certified operators collimate the x-ray beam somewhat better than noncertified for chest examinations. They also indicate that differences in collimation practices may be attributed to the type of facility as well as to the credentials of the operators. One-third of the medical x-ray machines are in states presently requiring licensure of operators. It appears from these estimates that instituting operator licensure in the remaining states may reduce population dose by a maximum of one or two per cent.