BfS information on age determination by means of x-ray examinations

Each x-ray examination presents a radiation risk

In medicine, x-radiation is used to diagnose diseases when other methods fail to provide a clear diagnosis. However, an x-ray examination is only justified if the patient has a benefit from the examination that outweighs the possible radiation risk. In line with practical radiation protection, one assumes for precautionary reasons that each x-ray examination presents a certain - if low - radiation risk.

In particular, it must be taken into account that the persons who are to be examined need special protection from the radiation point of view, as they are adolescents or young adults. The growing organism is more radiosensitive than the adult one. Furthermore, the probability for a triggered disease (leukaemia or cancer) to actually surface is clearly bigger in a young person than in an adult person.

Application of x-radiation must be justified

The Radiation Protection Act stipulates that the application of x-radiation in human beings must be justified. Details are regulated in the X-Ray Ordinance. Regarding the justifying indication, the Ordinance states the following:

The currently debated age determination by means of x-ray examination is not a diagnostic method from which a single person benefits. The X-Ray Ordinance also states requirements for this:

That means that in the application of x-radiation outside the medical field, a benefit – in this case a social benefit – must always be given that outweighs the possible radiation risk. In terms of age determination, the x-ray examination of, for example, the left wrist is of certain importance from the point of view of forensic medicine. However, it is scientifically disputed how individual differences, in particular life circumstances or developmental disabilities, affect the exactness of age determination. Age determination using this method is therefore subject to different degrees of uncertainties.

Low doses must be justified, too

With 0.5 microsievert, the effective dose from an x-ray examination of the hand is relatively low. It corresponds approximately to the dose a person is normally exposed to due to natural radiation during one hour. However, it must be justified, too. For comparison: A panoramic x-ray examination of the jaw results in a dose of 20 to 25 microsievert, a flight from Frankfurt to New York of 32 to 75 microsievert. Another method for age determination, the computer tomographic examination of the clavicles, results in a clearly higher radiation exposure of about 500 microsievert.