Little Feet, Be Careful!

Most children hate being fitted with new shoes--unless they are taken to a store where they can look at their toes in an X-ray fitting machine. Then it's fun. But last week, in the New England Journal of Medicine, Dr. Charles R. Williams of the Harvard School of Public Health warned about the harm that this type of fun might cause, through overexposure to X rays.

Typical machines in shoe stores, Dr. Williams found, deliver from five to 58 times the maximum dose considered safe by the American Standards Association and the New York City Health Department. The safe dose is two roentgens for each exposure. The safest machine examined by Williams delivered two roentgens in four seconds; the most dangerous delivered the dose in one-third of a second. Exposures range from five to 45 seconds; the one most often used is 20 seconds.

Even if a single dose is brought down within safe limits, a child is still in danger of overexposure. Most authorities set three exposures in one day, or twelve in a year, as the maximum allowable. But on many machines there is nothing to keep a moppet from pressing the button again & again to see his wiggling toes. And if mother is hard to please, the salesman will want to give her another look.

The most likely injury is to the growth of the feet, warns Dr. Louis H. Hempelmann in a companion article. A growing section of bone (the epiphysis) is much more easily damaged by X rays than adult bone. X rays are deliberately used to stunt the growth of one leg in a child whose other leg has been shortened by disease. Hempelmann suspects that such stunting might result from the use of X-ray shoe fitters, and go undetected for years.

Also likely to escape notice are radiation burns of the skin on the customer's feet, if they do not cause immediate reddening. Nobody knows exactly how much X ray can be given repeatedly without causing chronic skin damage. Dr. Hempelmann believes that the dangers could be controlled by regulating the use of the machines. Other doctors think that for normal feet the best shoe-fitting machine is a patient shoe clerk.

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