Chiropractor's use of radiography in Switzerland

Objective: In this article, we investigate the use of diagnostic radiology by chiropractors in Switzerland, with the aim of determining their contribution to the annual radiation collective dose. Methods: We approached 138 chiropractors possessing radiologic equipment and asked them to provide, among other information, the frequency of radiographic examinations. The dose associated with each type of radiographic examination was established separately. The collective dose was determined by convolution of frequency and dosimetric information. Results: The number of chiropractic radiographic examinations performed in Switzerland in 1998 was 60,000, mainly spinal and pelvic examinations. The associated annual collective dose was found to be 144 Sv (an annual effective dose of 20 μSv per capita).The chiropractic contribution to the total dose due to conventional radiography in Switzerland is about 6%. Conclusions: Considering the number of chiropractors in Switzerland (less than 200), their contribution to the collective dose is relatively high. This is due to the high effective dose associated with the main types of examinations performed (eg, lumbar spine). It is therefore necessary to develop and apply guidelines for the use of this type of radiographic examination, as well as quality control programs, in order to optimize the radiographic technique and hence reduce the doses. (J Manipulative Physiol Ther 2003;26:9-16)