Experimental investigation of commercially available lead composite aprons used for diagnostic X-rays

Shousha, Hany A.; Rabie, Nader; Hassan, G.M.

doi:10.1080/10420150.2011.559237

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…However, they assessed the effect of aprons directly in the beam path, rather than effects of scatter radiation, as surgeons encounter in the operating room. This was confirmed by Shousha et al which demonstrated differences between different materials with a lead-equivalency of 0.5 mm, measuring transmission rates of 1–14% relative to beam strength [27] . Jones and Wagner found an even greater variance in performance of lead-equivalent materials relative to beam voltage (kVp) values, to the point of questioning the utility of measuring the lead equivalence of protective garments [28] .…”

Section: Discussionmentioning

confidence: 53%

Efficiency of lead aprons in blocking radiation − how protective are they?

Hyun

Kim

Jahng

et al. 2016

Heliyon

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BackgroundDespite the firmly established occupational risk of exposure to X-rays, they are used extensively in spine surgeries. Shielding by lead aprons is the most common protective practice. We quantified the level of their radiation blocking ability in a real-life setting.MethodsSingle-center, prospective, randomized study of adult patients with degenerative lumbar disorders, scheduled to undergo posterior lumbar interbody fusion. Instrumentation was performed in either a robot-assisted, minimally invasive approach (RO) or a conventional, fluoroscopically-assisted, open approach (FA). Outcome measures included the quantitative measurement of the surgeon’s actual exposure to radiation, as recorded by thermo-luminescent dosimeters (TLD) worn both above and under the 0.5 mm thyroid and trunk lead protectors.FindingsSixty four patients were included in this study, 34 in the RO cohort and 30 in the FA cohort. The radiation blocked by the aprons, represented as the ratio of the under-apron to above-apron TLDs, averaged 37.1% (range 25.4–48.3%, 95% confidence interval between 30.6–43.6%). In the RO cohort, the average per-screw radiation dose and time were 51.9% and 73.7% lower, respectively, than the per screw exposure in the FA cohort.InterpretationThe 0.5 mm lead aprons blocked just over one third of the radiation scattered towards the surgeon. Use of robotic-guidance in a minimally invasive approach provided for a reduction of 62.5% of the overall radiation the surgeon was exposed to during open conventional approach. We conclude that reduced radiation use (e.g. by using robotic guidance) is a more effective strategy for minimizing exposure to radiation than reliance on protection by lead aprons, and recommend utilization of practices and technologies that reduce the surgical team’s routine exposure to X-rays.

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Section: Discussionmentioning

confidence: 53%

Efficiency of lead aprons in blocking radiation − how protective are they?

Hyun

Kim

Jahng

et al. 2016

Heliyon

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“…The vast majority of pieces of PRPE were available for several users. The right fit is important to lower the risk of unnecessary tension on the garment and ensure adequate shielding efficacy [ 26 , 31 ]. Consequently, this hindered an analysis of the association between tears and the clinical tasks performed by the corresponding user.…”

Section: Discussionmentioning

confidence: 99%

Integrity of personal radiation protective equipment (PRPE): a 4-year longitudinal follow-up study

et al. 2022

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Background Personal radiation protective equipment (PRPE) such as lead aprons minimises radiation exposure of operators using X-ray systems. However, PRPE might be prone to cracks in the attenuating layer resulting in inadequate radiation protection. This study aims to investigate the prevalence, qualification and quantification of PRPE integrity during a longitudinal follow-up study. Methods All PRPE of a large, general hospital was evaluated yearly in the period 2018–2021. The equipment was inspected on a tele-operated X-ray table, and tears were qualified and quantified using an X-ray opaque ruler. Rejection criteria of Lambert & McKeon, with an extra rejection criterion of 15 mm2 for individual tears, were applied to accept or reject further use of the PRPE. Results Over the 4-year follow-up period, a total of 1011 pieces of PRPE were evaluated. In total, 47.3% of the PRPE showed tears of which 31% exceeded the mentioned rejection criteria. Remarkably, of the 287 newly registered pieces of PRPE, 6.0% showed tears in the first year of use of which 88.2% needed to be rejected. Also, 48% of the repaired PRPE was rejected again in the consecutive year. Conclusions PRPE is prone to cracks. Up to 50% of PRPE showed tears and cracks resulting in 31% rejections. Newly purchased PRPE is not guaranteed to remain free of cracks and tears in the first year of use. Repair does not guarantee a long-term solution for prolonging the lifespan. Regular X-ray-based integrity analysis of PRPE is needed to ensure adequate radioprotection for operators using X-ray systems.

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“…Lead-free and lightweight aprons are generally presented in market with eco-friendly labels which also promise wearing comfort with their reduced weights. In literature, the performance of commercial lead and non-lead aprons has been investigated in some papers (Lu et al, 2019, Shousha et al, 2011, Finnerty and Brennan 2005, Papadopoulos et al 2009. According to various studies (Lu et al, 2019, Peters et al, 2017, Eder et al, 2010, Finnerty and Brennan 2005, Papadopoulos et al 2009, some of the aprons that are in use cannot meet the required protection levels, which is conflicting with the claims of companies.…”

Section: Introductionmentioning

confidence: 99%