Between the 1920s and 1950s, many shoe stores in America and Europe equipped themselves with direct X-ray machines, allowing customers to choose well-fitting shoes.
X-ray shoe fitting devices in the early 20th century were known as fluoroscopic shoe fitting machines, resembling luggage checking equipment at airports but smaller in size. These machines clearly displayed the bones and flesh of the foot along with the shoe outline, helping customers avoid guesswork and select better-fitting shoes.
Front and side view of the fluoroscopic shoe fitting machine. (Photo: Wikimedia).
The fluoroscopic shoe fitting machine consisted of an upward-facing X-ray tube mounted inside the bottom of a metal box, with a fluorescent screen above and three observation ports. An opening on the side of the box allowed customers to place their foot between the tube and the fluorescent screen. The X-rays penetrated the shoe and foot, striking the fluorescent screen and illuminating it with an image of the customer’s foot. Customers, sales staff, and others could view this image through the three observation ports.
The machines were usually shielded, but sometimes essential shielding panels were removed to enhance image quality or reduce the machine’s weight. Consequently, a significant amount of radiation was scattered in all directions, exposing both the customer and the salesperson to radiation. A single exposure typically lasted about 20 seconds, emitting radiation equivalent to roughly half a chest CT scan.
Many machines were poorly maintained and emitted radiation at potentially dangerous levels. Some particularly inadequate machines emitted radiation up to 300 times the permissible limit. Even individuals waiting in the lobby were exposed to this radiation. The situation was further exacerbated as customers rarely tried on just one pair of shoes and often returned multiple times.
The greatest risk was faced by sales personnel. They endured scattered radiation exposure throughout the day, every working day. In a 1957 issue of The British Medical Journal, expert H. Kopp from the Finsen Institute in Copenhagen described the case of a 56-year-old woman suffering severe pain and skin lesions on her right leg and foot, consistent with radiation burns.
Upon inquiry, doctors discovered that she had worked in a shoe store for 10 years. She operated the fluoroscopic shoe fitting machine 15 to 20 times a day, even sometimes placing her own foot in the machine to demonstrate to frightened children that it did not cause pain.
The fluoroscopic shoe fitting machine was once popular in high-end shoe stores. (Photo: Amusing Planet)
The shoe fitting machine was originally designed by Dr. Jacob Lowe to X-ray the feet of injured soldiers during World War I without removing their shoes. The device expedited treatment, allowing Lowe to examine many patients in a short time. After the war, he adapted the device for shoe fitting and first introduced it at a shoe retailer conference in Boston in 1920. Seven years later, he received a U.S. patent for the machine.
During this time, a similar machine called Pedoscope was also patented in the UK. Within a few years, the fluoroscopic shoe fitting machine and Pedoscope became highlights in high-end shoe stores across the UK and North America. By the 1950s, at the height of their popularity, there were up to 3,000 machines in the UK, 10,000 in the U.S., and 1,000 in Canada.
In 1927, American scientist Hermann Joseph Muller published a study linking the incidence of bone cancer in radium watch dial painters to long-term radiation exposure. However, there was insufficient data to quantify the level of risk. Following the bombings of Hiroshima and Nagasaki, scientists began to understand the long-term effects of radiation.
In 1946, for the first time, the American Standards Association issued guidelines for the production of fluoroscopic shoe fitting machines, setting limits on the amount of radiation the devices could emit. Shoe stores were also required to place warning signs on the machines, recommending that customers not be exposed more than 12 times a year. However, a study conducted two years later in Detroit found that most machines still emitted dangerous levels of radiation, raising concerns across the United States. Subsequent surveys in 40 states revealed that 75% of the machines were unsafe.
The first warnings were issued in 1950, and fluoroscopic shoe fitting machines gradually disappeared from stores. However, it wasn’t until three decades later that the last machines were finally taken out of operation.
