Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

Abstract

Shielding has been recommended as an effective tool against radiation exposure. Several studies have published on the availability and use of shielding tools in diagnostic X-ray centers across the country and contradictory results been reported. Therefore, the aim of this systematic review was to find out the status of radiation protection in term of availability and use of shielding tools in diagnostic X-ray centers in Iran. An extensive literature search was conducted in the PubMed/Medline, Embase, ISI, Cochrane Library, SID, Magiran, IranMedex, Irandoc and Google-Scholar search engine. We also manually searched the reference lists of the relevant studies. Two authors independently assessed the eligibility of all studies and extracted data. Thirty-seven studies published from 1998 to 2019 were included in this systematic review. In all, 1089 diagnostic X-ray centers, 4439 radiographs and performance of 1472 radiographers were covered in these studies. The availability of lead apron, gonad shield and thyroid collar were ranged from 7 to 95.5%, 26.6 to 94% and 7 to 94%, respectively. Moreover, their usage was ranged from 0 to 85.5%, 0 to 35% and 0 to 38.4%, respectively. In addition, lens shield was discussed in one study with availability of 0%. During 1998 to 2019, the status of shielding had not improved across the country. Therefore adherence to the safety guideline as far as possible is required to protection patients from undue exposure to radiation.

<p>Effectiveness of Breast and Eye Shielding During Cervical Spine Radiography: An Experimental Study</p>

“…23 Similarly, Ciarmatori et al (2016) documented a significant dose reduction in the eye lens dose (28.5 ± 5%), and image quality was not affected by shielding during head Computed Tomography (CT). 24 The radiation dose reduction up to 50% with no effect on image quality has been reported in eye during head CT. 25,26 Similar results were noted when shielding the breast in fluoroscopy, 27 CT head scan, 28,29 and lumbar radiography examinations. 19 The eye lens is highly radiosensitive, especially in children, but studies on the radiation dose to the eye lens are scarce and focused on CT.…”

“…21 Several radiosensitive tissues such as the eye lens, thyroid gland, breast, and gonads may benefit from shielding. 26 In CS radiography, the possibility of incorrect shield positioning is limited as the shield is never on the area under examination. Incorrect positioning of the gonad shielding during pelvic radiography in both women and men can lead to increased dose due to incomplete coverage of the gonads.…”