Chiropractors and x-ray devices - a stronger focus on the safe use of this equipment.

Monitoring by ANVS has revealed that some chiropractors who use x-ray devices and advertise this service on their websites, often do not have a licence for this type of work. These chiropractors will now be required to apply for a licence before they can use their x-ray devices again.

Enlarge image chiropractor achter beeldscherm met röntgenfoto om botdichtheid te meten
Image: ©ANP

DEXA machine for measuring bone density and for detecting osteoporosis.

Some chiropractors use DEXA machines to make scans of bones. DEXAs are X-ray devices. These types of scans provide insight into a patient’s bone density, making it possible to detect osteoporosis. Chiropractors use this information to create a suitable treatment plan. Before making these scans, they need a referral from a doctor (such as a radiologist). Agreements need to already be in place between the chiropractor and the doctor.

The Authority for Nuclear Safety and Radiation Protection assesses the safe use of x-ray devices in the licence application

Anyone using a DEXA for bone scans requires a licence issued by the Authority. When we receive an application for a licence, we assess whether or not its use is in compliance with safety requirements. For example, a radiation protection expert needs to be involved. In addition, unauthorised persons may not have access to the X-ray device. Chiropractors should also have their equipment checked every year.

Monitoring of 10 chiropractors led to licence applications

At the end of 2023, we contacted 10 chiropractors who offered scans using a DEXA as a service on their websites. It turned out that several clinics were no longer in possession of a DEXA. The others were still in possession of a device, but did not have a licence. At present, we have received multiple licence applications and have already issued several licenses.

Information via the Dutch Chiropractors Association

We are currently having conversations with the Dutch Chiropractors Association. Via this association we plan to inform chiropractors who intend to start using x-ray devices about the requirements. During our monitoring, we will establish whether or not a chiropractor has the appropriate licence.

Applying for a licence from the Authority

Does your care provision include the use of x-ray devices? And are you not yet in possession of a licence? Then you should apply for a licence (in Dutch).

How safe are x-rays?

Small amounts of radiation are used in taking x-ray images. This radiation is useful, but could also damage cells and DNA. To prevent unnecessary damage, there are requirements for the use of x-ray devices. Unauthorised or unintended use should be avoided. The Authority therefore monitors the use of x-ray devices, in cooperation with other regulators such as the Netherlands Labour Authority and the Health and Youth Care Inspectorate.