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Introduction

How do you know if you have shoes that fit well? How can parents tell if the new shoes for their child has adequate room for growth? While this new style of shoes is attractive, can I wear them given the condition of my feet? For many years, people had to rely on their own judgement or that of a knowledgeable shoe salesman for answers. Then along came technology that offered easy answers. It was the shoe fitting fluoroscope.

 

 The Shoe Fitting Fluoroscope

The shoe sitting fluoroscope arrived in the 1920s. About that time, it followed the introduction of electricity in many homes that created new labor saving and enhancing devices and laid a groundwork for acceptance of technology into everyday life. Housewives in particular valued not only improved lighting, but also refrigerators, stoves, irons, mixers, vacuums and other items that improved everyday homemaking. At that time technology in the shoe store improved a basic task, getting a good fit.

The shoe fitting fluoroscope used x-rays so that one could actually see how well feet fit inside a pair of shoes. Figure 1 shows what the machine looked like. It had an attractive, modern-looking furniture-style cabinet. There was a low platform the customer stood on and inserted the forward portion of the feet into an opening. On the opposite side was a switch by which the shoe salesperson could turn the machine on. In most models there were three viewing ports. One was positioned at the customer side and the other two were on the opposite side, with one for the shoe salesperson and the other for a second person. This third viewing port was most often for a parent of a child who was trying on new shoes.

Underneath the feet was an x-ray generator. Above the feet was a fluorescent screen that showed the x-ray view of the feet and shoes. Figure 2 provides an example of what the image might look like.

For kids, the x-ray view of the feet was awesome. One could wiggle the toes and see them in the image. For parents, one could see how much space existed between the tips of the toes and the end of the shoes. It was technology at work. The opinion of the shoe salesperson added to the experience and confirmed what a parent saw.

The shoe fitting fluoroscope was an outstanding sales tool for any shoe store that had one. If the image for a more expensive pair of shoes was better than a less expensive shoe, the image confirmed the value of the expensive pair. 

History of the Device

X-rays were discovered by Wilhelm Roentgen in 1895. Within a few years, the use of x-rays became a valued tool in medicine to observe some internal conditions not otherwise available to a physician.

The idea of using x-rays to diagnose proper fit of shoes began in the military just prior to WWI. During the war Dr. Jacob Lowe of Boston devised a fluoroscopy machine to examine soldier’s feet without removing their boots. After the war he modified his apparatus for use in retail shoe fitting, saw the marketing potential and demonstrated it at a convention in Boston in 1920. By 1927 he received a patent for his machine. It appears that the Brouwer Shoe Store in Milwaukee, Wisconsin started to use x-ray fitting of shoes already in 1919. That led to the X-Ray Shoe Fitter Corporation and then the Adrian Company, both of Milwaukee, that manufactured the devices for distribution and use in the shoe sales industry.

Almost concurrently, use of x-rays in shoe fitting occurred in England. The x-ray machine there became known as the Pedoscope, manufacture by the Pedoscope Company. It became one of the primary produces of the machines.

Use of the devices expanded from the United States and England to Canada, Australia and other countries. At the high point of use, estimates suggested that there were more than 10,000 shoe fitting fluoroscopes in use in the United States, 3,000 in the United Kingdom, 1,500 in Switzerland and a thousand in Canada.

A shoe fitting fluoroscope sold for a little less that $1000 to as much as $2000.

Use of the machines grew quickly in the 1930s and 1940s and reached their peak of popularity in the early 1950s. However, use faded fast late in that decade.

How the Device Became Popular

In the decades of the 1920s and 1930s, most households had one breadwinner, the father. Women managed the household and children. Not everything was offered in convenient forms and materials. Products for households were not as convenient. As noted, electricity had reached most urban households and added efficiency to may daily tasks. That was one form of technology that caught people’s attention, acceptance and appreciation.

In addition, medicine had adopted the use of x-rays as a very common medical diagnostic technology. Patients had become familiar with x-rays and their value. So the presence of x-rays for shoe fitting in shoe stores added to the importance and acceptance of technology.

Compared to today when every department store, discount store and sporting goods store sells shoes, at that time there were stores that sold shoes only. That is where one went to buy shoes for everyone in the family.

The key person involved in the decisions and transactions was the shoe salesperson, most often a shoe salesman. He had to be a good promoter and marketing person. Not all shoe choices were on display. He had to interpret what a customer was looking for and then bring out several options that met the request. On some occasions, a second round of options was required.

Once choices were identified, the job was to try them on the customer. The shoe salesman put the shoes on the customer’s feet and helped the customer evaluate them for quality, appearance, and fit.

The shoe salesperson saw the shoe fitting fluoroscope as a marketing tool more than anything else. It was a way to enhance what the salesperson had already said in promoting a shoe. It allowed a customer or parent to confirm information already established in the sales process. For children, it was an awesome experience that helped them confirm what their mother or parent saw in the images.

Using the Device

After trying on shoes and making a preliminary selection, a customer stepped on the machine’s platform, placed the toes into the opening and the salesperson turned on the machine. In some models, there was a timer that limited the x-ray exposure to about 20 seconds. Whoever was looking at the images, could confirm any decisions regarding fit. It provided scientific evidence for the shoe buying decision.

Children, along with parents, sought the shoe store that had a shoe fitting fluoroscope. It was the fitting and buying experience that sold the shoes.

In some cases, children would try to stop at their local shoe store whenever possible to see their toes wiggle. Here are some recollections:

“I definitely remember my older brother and I x-raying each others feet while our mom was with the salesperson, fitting our younger brother.”

“I can’t remember how many times my friends and I used to use the shoe-store fluoroscope to look at any parts of our bodies we could fit into the slot.”

“The shoe store was on my route to school. My friend and I would enter the store to x-ray our feet almost every morning and afternoon for a few months before we moved to a different town.”

The shoe fitting fluoroscope was definitely an advertising and marketing device for several decades. A shoe store without one was at a severe disadvantage for shoe sales.

Dangers and Level of Exposure

A major problem with the shoe fitting fluoroscope was the amount of radiation created and its lack of shielding to prevent exposures in the entire area around the machine. Early on that was not an issue, but over time it was important. Later models did increase shielding to some extent. However, the public eventually became aware of the hazards of x-rays, even during shoe fitting.

The danger to infrequent users was rather low since the exposure time was only a few seconds. The greatest danger was to shoe salespeople who operated the machine frequently and had repeated exposures during their sales careers.

There are several measures for X-ray radiation. There are physical measures. The amount of radiation released is the curie (Ci) in British Units and becquerel (Bq) in metric units. The amount of x-ray radiation traveling through the air is the Roentgen (R).

There is also the amount of radiation absorbed. The amount absorbed by the tissue of a person in British Units is the rad. The metric unit is gray (Gy).

There are also units indicating the radiation producing a biological effect. The unit of biological effect is Rem (roentgen equivalent man). The metric unit is sievert (Sv). The effects produced are described in dose equivalence. For example, the biological effect produced by a dose of 1 R of x-rays is 1 rem. In many cases dose equivalents are given in smaller units, such as millirem (mrem).

As the concern for the potential radiation hazards produced by the x-rays from a shoe fitting fluoroscope grew, several sought to measure what exposure actually occurred. They found a range of results:

  • In 1940 estimated doses at the feet ranged from 7 to 14 R for a 20 second exposure. At the pelvis the exposure range was 30 to 170 mrem
  • In 1946 a survey indicated an exposure at the machine ranged from 16 to 75 R for one minute.
  • In 1949 a measurement indicated 0.5 to 5.8 R/sec at the feet and greater than 100 mR/hr ten feet in front of the machine.

Late in the history of use for these machines, it was clear that exposures exceeded newly developed standards.

Emerging Exposure Standards and the Demise of the Shoe Fitting Fluoroscope

In 1946 the American Standards Association created a “safe standard or tolerance dose” of x-rays for feet. That standard was 2 R per 5 seconds of exposure. Children were to receive no more than 12 such exposures in a year. That was followed by several state standards. The widening range of standards made it difficult to claim compliance.

The shoe fitting fluoroscope manufacturers engaged the American Conference of Governmental Industrial Hygienists to create a standard. ACGIH completed that standard in 1950. It allowed the manufacturers to claim compliance with the standard.

However, warnings about x-ray exposures from shoe fitting machines grew along with a variety of restrictions on who could operate them. In 1957 Pennsylvania banned their use. About that time insurance companies began making it difficult to get coverage for the machines. As a result, the use of shoe fitting fluoroscopes essentially ended about 1960 in the United States. Similar restrictions did not seem to impact their use in other countries until about 1970.

Individual Cases

Over the years there is no record of shoe store customers having received a radiation injury.

However, there are a few records of shoe salespersons who had radiation injuries.

In some cases the salespersons put their hands into the foot opening to squeeze the toes during a fitting. One such saleswoman who operated a shoe fitting machine 10 to 20 times per day for more than 10 years developed dermatitis of the hands.

There is also a record of a shoe model who received severe radiation burns to her leg, resulting in amputation.

There was also a case of basal cell carcinoma. There is some indication that the machines may have led to unusually high rates of foot cancer.

Overall, the shoe fitting fluoroscope proved to be a useful shoe sales device. The technology it presented to the public was well accepted. However, in time the novelty faded and the need to protect the public from unnecessary radiation became the responsible approach.

References

The most comprehensive report on the history of the shoe fitting fluoroscope is:

Jacalyn Duffin and Charles R. R. Hayter, “Baring the Sole: The Rise and Fall of the Shoe-Fitting Fluoroscope,Isis, Vol. 91, No. 2, June 2000, pages 260-282.

Significant Internet articles on the shoe fitting fluoroscope include:

There are many other articles speaking about the novelty of the shoe fitting fluoroscope.

Other sources:

  • Kopp, H. “Radiation Damage Caused By Shoe-Fitting Fluoroscope.” The British Medical Journal, Vol. 2, No. 5057, 1957, pp. 1344–1345.
  • Leon Lewis and Paul E. Caplan, “The Shoe-Fitting Fluoroscope as a Radiation Hazard,” California Medicine, Vol. 72, No. 1, 1950, pp. 26-30.

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