This article is history, not medical or safety guidance. Modern radiation protection is governed by specialist standards and professionals, and nothing here describes current practice or what is right for any individual.
A Hazard Nobody Could Feel
X-rays can’t be seen, felt or smelled. A person standing in front of a running tube in 1896 had no warning that anything was happening. That is the central fact behind the injuries of the early years. The rays were exciting, the equipment was new, and the harm they could do was delayed, which made the connection easy to miss.
Early exposures were also much larger than anything used now. Tubes of the time were inefficient, images took minutes, not fractions of a second, and operators were often close to the tube for hours. Individual doses were not measured, because there was no practical way to do it.
The First Reports of Harm
Reports of skin damage appeared within months of the discovery. In 1896, physicians and experimenters described reddening of the skin, hair loss, burns and slow-healing sores in people who had been exposed, either from long experiments or from medical imaging. Some early burns were severe. At first, there was disagreement about the cause. Some blamed the electrical equipment, ozone, or ultraviolet light from the tube, and the idea that the rays themselves were responsible took time to settle.
The injuries were not limited to patients. Operators, who examined hands by placing them in the beam (sometimes their own, to check the tube was working), suffered the most from repeated exposure. Reports of chronic skin changes, of ulcers and, in later years, of cancers began to accumulate.
The “Martyrs” of Radiology
Many of the best-known early radiographers developed serious conditions. One frequently cited case is Clarence Dally, who worked as an assistant to Thomas Edison on X-ray devices and fluoroscopes. Dally suffered severe injuries to his hands and died in 1904, a case widely reported at the time. Edison himself reportedly stopped working on the rays, although accounts of how much his own health was affected vary.
Others, in Britain, Germany, the United States and elsewhere, lost fingers, hands or arms to repeated surgery, and some died from cancers that were attributed to exposure. A memorial to X-ray and radium victims was erected in Hamburg in the 1930s, bearing the names of people from many countries. The numbers on such memorials grew over the years, and exact counts are hard to establish. The term “martyrs of radiology” came to be applied to the pioneers who were harmed.
It is worth being careful here. It is often difficult to be sure which illness in a particular person was caused by exposure, and some stories have been simplified in retelling. The overall pattern, however, is well accepted: early workers had higher rates of radiation injury than the public at large.
First Steps Toward Protection
Protective measures were proposed quite early, though not systematically.
- Shielding. Lead and other dense materials block the rays well, and some users began to enclose the tube in a shield with only a small opening, or to put protective material around the operator. Some early attempts in the late 1890s and 1900s are attributed to individual doctors, including American dentist William Rollins, who published advice about protection and about limiting exposure. He is often credited as an early advocate, although many people were thinking along similar lines.
- Shorter, fewer exposures. Improved tubes and faster plates and screens meant less time in the beam, which reduced the dose for each image.
- Distance. Because intensity falls off quickly as distance increases, working further from the tube reduced exposure.
- Filtering. Placing thin metal between the tube and the patient absorbed the softest rays, which contributed to skin damage without helping the image.
These measures were taken up unevenly, and for years many working radiographers did not use them.
Measuring a Dose
One of the barriers to safety was that no one could say how much radiation a person had received. Early attempts to measure exposure used the effects themselves, such as the reddening of the skin or the darkening of photographic film or certain chemical pastilles. These were crude. Over the first decades of the twentieth century, instruments based on the ability of the rays to ionize air were developed, and it became possible to define a unit of exposure. The idea of a “tolerance dose” appeared in the 1920s, which was a rough estimate of an amount that workers could receive without visible harm. The concept has since been replaced by a more cautious approach, in which the aim is to keep exposure as low as reasonably achievable. Measuring devices of other kinds, such as those used for radiation detection, also developed along with the science of radioactivity.
Committees and Standards
International organization came later. In 1928, the second International Congress of Radiology established what was then called the International X-ray and Radium Protection Committee, a forerunner of the International Commission on Radiological Protection, which continues to publish recommendations. National bodies were also created, and recommendations on limits for workers and the public were revised several times as evidence accumulated. In general, recommended limits became lower over the decades as understanding of long-term risk improved.
Other Episodes
The enthusiasm for the rays in the early twentieth century sometimes led to uses we would now consider unwise. A well-known example is the shoe-fitting fluoroscope, a machine found in some shoe stores from about the 1920s to the 1950s that showed the bones of the foot inside a shoe. It was eventually phased out as the risks of unnecessary exposure were better understood. Another was the use of the rays in attempts at hair removal and in treating various conditions, some of which later proved harmful. These episodes show how long it took for caution to catch up with enthusiasm.
What the History Shows
The history of X-ray safety is often presented as a lesson in how a powerful technology can be used well before its risks are known. The X-ray machines themselves changed in response: tubes were enclosed in protective housings, controls became more precise, and rooms were designed to contain the rays. Medical use continues today, but it is regulated and managed by trained professionals who weigh benefits against risks for each patient. Outcomes in any medical situation are uncertain, and this article should not be taken as a guide to any of them.