Clinical Evaluation of Protective Garments with Respect to Garment Characteristics and Manufacturer Label Information

Lichliter, Andrew; Weir, Victor; Gipson, Sean; Syed, Almas; West, James L.; Rees, Chet R.

doi:10.1016/j.jvir.2016.08.006

Cited by 17 publications

(18 citation statements)

References 11 publications

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“…Different leadequivalent thicknesses are available, as are lighter-weight protective aprons that contain an attenuation material other than lead. The lead-equivalent thickness of the apron may also differ from the stated lead-equivalence thickness on the apron label (Lichliter et al, 2017). The Commission, therefore, maintains the principal recommendation to use the double-dosimeter approach with a simple algorithm, such as one of those found to meet the criteria and proposed in the CONRAD study (see Table 4.1).…”

Section: Recommended Option For the Assessment Of Effective Dosementioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

167

123

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In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

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Section: Recommended Option For the Assessment Of Effective Dosementioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

167

123

View full text Add to dashboard Cite

show abstract

“…3,5e9 Studies have reported composites transmitting as much as double the radiation of equivalent lead only aprons, 7 with non-lead composites failing to provide better attenuation per unit weight than lead only and lead containing composites. 15,16 Lichliter et al found up to 12 fold transmission differences for composites labelled 0.5 mm Pb LE. 15 Although some studies have found that composites are equivalent or better than lead at certain tube voltages it must be stressed that for adequate protection garments need to provide protection across a wide range of Xray voltages.…”

Section: Radiation Physics and Performance Of Composite Garmentsmentioning

confidence: 97%

“…15,16 Lichliter et al found up to 12 fold transmission differences for composites labelled 0.5 mm Pb LE. 15 Although some studies have found that composites are equivalent or better than lead at certain tube voltages it must be stressed that for adequate protection garments need to provide protection across a wide range of Xray voltages. 17,18 This study has demonstrated a wide variation in compliance to labelling standards and protection provided by radiation protection garments tested in a real world setting.…”

Section: Radiation Physics and Performance Of Composite Garmentsmentioning

confidence: 97%

Lightweight Lead Aprons: The Emperor's New Clothes in the Angiography Suite?

Boyd

Dawson

2019

European Journal of Vascular and Endovascular Surgery

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The aim of this study was to test the performance and labelling of garments that are in contemporary use for radiation protection. A significant proportion of garments failed to comply with international labelling standards and did not provide the protection claimed by manufacturers. In addition, garments labelled at the same lead equivalence performed vastly differently in attenuation of scatter. These findings were demonstrated in the real world setting, by testing garments that are in current use across multiple centres. The study highlights current concerns regarding radiation protection standards and the need to identify composites that can consistently provide better protection than lead. Objective: The aim was to determine whether lead containing and lead free composite garments in current use provide the level of radiation protection stated by manufacturers. Methods: Fifteen garments, produced by five different manufacturers using eight different composites, were randomly selected for testing from four hospitals in South Australia. Labelling, material composition, design, and condition of the garments were assessed by direct garment examination, garment label, and product information. Garment attenuation was tested in a simulated angiography suite using a Siemens Ysio Max digital Xray machine. The front and back panels of each garment were tested under direct beam at 100 kVp. A Perspex phantom was used to simulate the density and scatter properties of the human abdomen. The front panels of each garment were tested under scattered radiation at Xray tube voltages of 50 and 70 kVp. Results: Forty-seven per cent of front panels and 90% of back panels provided lower lead equivalence than claimed by the manufacturer. Twenty per cent of front panels and 62% of back panels tested did not meet the minimum International Electrotechnical Commission requirements for angiographic use. There was a 38 fold difference in front panel performance of garments to scatter radiation, which were all labelled 0.5 mm lead equivalence. 56% of garments had differences in scatter transmission of at least 49% when tested at 50 and 70 kVp. Conclusion: The results show that lead containing and lead free composite garments probably provide less radiation protection than manufacturer stated lead equivalence. The demonstrated wide variations in attenuation of scatter radiation are greater than previously reported. It was found that most garments failed to comply with labelling standards. The study highlights challenges in radiation shielding and the need to identify composites that consistently provide better attenuation per unit weight than lead.

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“…In-house validation of aprons for radiation safety should be done as different aprons provide varied radiation protection even if labeled as having equal lead equivalence. 49 Eyes are very sensitive to harmful effects of radiation, so, protective eye goggles with large lenses are recommended for lenticular protection. The amount of radiation protection with lead gloves is debatable.…”

Section: Radiation Protection Gearmentioning

confidence: 99%

Radiation Concerns for the Neuroanesthesiologists

Burman

Das

Mahajan

et al. 2020

Journal of Neuroanaesthesiology and Critical Care

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With the advent of minimally invasive neurosurgical techniques and rapid innovations in the field of neurointervention, there has been a sharp rise in diagnostic and therapeutic modalities requiring radiation exposure. Neuroanesthesiologists are currently involved in various procedures inside as well as outside the operating room (OR) like intensive care units, interventional suites, and gamma knife units. The ambit expands from short-lasting diagnostic scans to lengthy therapeutic procedures performed under fluoroscopic guidance. Hence, a modern-day neuroanesthesiologist has to bear the brunt of the radiation exposure in both inside and outside the OR. However, obliviousness and nonadherence to the relevant radiation safety measures are still prevalent. Radiation protection and safety are topics that need to be discussed with new vigor in the light of current practice.

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Clinical Evaluation of Protective Garments with Respect to Garment Characteristics and Manufacturer Label Information

Cited by 17 publications

References 11 publications

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

Lightweight Lead Aprons: The Emperor's New Clothes in the Angiography Suite?

Radiation Concerns for the Neuroanesthesiologists

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