Are Front Shielding Lead Skirt Aprons Effective for Radiation Protection During Pregnancy?
Radiation protection is crucial for all healthcare workers exposed to radiation during diagnostic imaging and interventional surgery while using equipment like X-rays, C-arms, and fluoroscopy. However, the concerns are even greater for pregnant workers who need to protect a developing fetus, making it even more important to wear the right protective garments like lead aprons or skirts. Minimizing radiation exposure is vital for long-term health and safety, particularly in high-use environments.
How do you ensure safety, and are front shielding garments enough? We’ll review what you should know about radiation safety during pregnancy here, as well as tips that can help safely manage protective garments throughout their lifecycle, including deep cleaning, inspections, and lead garment recycling. The proper use of lead shields significantly reduces exposure to scatter radiation, offering critical additional protection.
Can You Use a Lead Apron When Pregnant?
Pregnant healthcare workers can and should wear lead aprons. It’s even more important to wear the appropriate shielding during pregnancy to minimize radiation exposure as much as possible while conducting diagnostic imaging or interventional surgery. Fetal exposure must be minimized to prevent both deterministic effects and stochastic effects, especially during early development.
A study from the Journal of American Family Physicians found that there are several health risks associated with high levels of radiation exposure during pregnancy. The research found increased risks of childhood cancer, spontaneous abortion, cognitive impairment, and growth restriction when exposure levels aren’t managed appropriately. Monitoring pregnancy status before each radiological procedure helps ensure safe practices for all involved.
Fortunately, wearing personal protective equipment (PPE) such as lead aprons and skirts can help pregnant women remain under established fetal dose limits while continuing to work. Healthcare facilities are encouraged to consult with a radiation safety officer when assessing pregnancy-related dose risks.
A study published by Seminars in Interventional Radiology found that wearing 0.5 mm lead aprons helped significantly reduce exposure for pregnant healthcare workers. Additionally, wearing thicker 1 mm maternity lead aprons provided even better protection that helped pregnant workers remain under dose limits for the entire 40 weeks of pregnancy. This effectiveness depends on factors such as lead equivalence and correct fit.
How Effective Are Front Shielding Lead Skirt Aprons for Fetal Radiation Exposure?
A study published by the Journal of Nuclear Medicine found that wearing front-only lead skirt aprons reduced radiation exposure by 6 times. Wearing frontal-only shielding during certain procedures can help since it’s often lighter than a full wraparound lead apron. Still, full front and back protection may be needed when exposure risks are multidirectional.
However, it depends on the procedure’s needs. A study published by the Journal of Radiation Protection Dosimetry recommended that all healthcare workers wear wraparound lead aprons during any procedures where clinicians will frequently have their backs turned toward the radiation source to ensure adequate protection to the full body. Weight distribution is another factor to consider, especially when aprons must be worn for long durations.
The study found that wearing wraparound coverage during procedures where clinicians were frequently bending, turning, or operating at different angles significantly reduced radiation doses to the full body compared to frontal-only coverage. Modern designs offer reduced weight without compromising protection.
What Are the Guidelines for Radiation Protection During Pregnancy?
Several governing bodies provide strict recommendations for occupational radiation exposure during pregnancy:
The U.S. Nuclear Regulatory Commission (NRC) recommends a dose limit of 5 mSv of radiation during the duration of the pregnancy.
The International Commission on Radiological Protection (ICRP) recommends a dose limit of 1 mSv of exposure during the entire pregnancy.
The National Council on Radiation Protection (NCRP) recommends a dose limit of 0.5 mSv per month throughout the pregnancy.
Each governing body has a slightly different recommendation, so it’s important to minimize exposure as much as possible to ensure safety. An abdominal dosimeter helps track absorbed dose and ensures dose limits are respected.
Research published by EuroIntervention emphasized the need for pregnant workers to follow the principles of ALARA (as low as reasonably achievable) to remain under established dose limits. That includes wearing PPE like lead aprons, reducing exposure time, or increasing distance from the radiation source. Use of thyroid shield accessories also provides targeted protection to vulnerable tissues.
However, reducing exposure time or increasing distance aren’t always possible during every procedure, so wearing appropriate shielding is a crucial step to ensure safety. Half aprons are another option for clinicians requiring flexible coverage in low-risk scenarios.
Why Are Lead Aprons No Longer Recommended in Some Settings?
When you hear that lead aprons are no longer recommended, it’s likely referring to regulation changes for dental X-rays. The American Dental Association (ADA) changed its guidelines in February of 2024, stating that lead aprons are no longer required during dental X-rays due to advancements in technology that reduce exposure levels significantly. However, a working interventional radiologist still requires multiple layers of protective gear due to high exposure.
However, those standard changes don’t apply to exposure in healthcare settings. Using proper radiation safety practices is still crucial while using equipment like C-arms and fluoroscopy that emit much higher radiation doses. Shielding is especially crucial for pregnant workers who need to minimize exposure as much as possible.
How Do You Choose the Right Lead Apron During Pregnancy?
Healthcare facilities that are trying to decide between frontal-only coverage or full wraparound aprons should assess the needs of each procedure that pregnant workers are involved in and work with their radiation safety officer (RSO) to form an appropriate shielding strategy.
Your RSO can work with pregnant healthcare workers to determine shielding accommodations that are the most comfortable for them and ensure that doses are appropriately tracked across procedures to avoid exceeding recommended limits. The study mentioned before from EuroIntervention recommended that pregnant workers wear abdominal dosimeters to accurately track doses during procedures.
Our team at Radiological Care Services (RCS) can also help you source high-quality PPE from top manufacturers. That includes lead aprons, maternity aprons, two-piece vest and skirt sets, thyroid collars, and lead glasses. All garments we help source are inspected, tagged, and arrive at your facility ready for use.
How Do You Maintain Lead Aprons Throughout the Gestational Period?
Properly maintaining lead garments throughout their lifespan is crucial for the safety of all healthcare workers, especially pregnant women with stricter dose limitations.
The Importance of Regular Inspections
All lead garments will accumulate wear and tear during use. When significant damage occurs, it can affect the fit of garments or result in cracks, holes, or tears in the attenuation material that lets more radiation through. A study from Radiography Open found that such damage can reduce the effectiveness of protective garments.
Garment integrity inspections can help identify damage early before it gets out of hand. A 2018 study recommended performing regular inspections using X-ray scanning to accurately identify small damage early and repair it before it gets worse.
The Importance of Regular Deep Cleaning and Disinfection
AORN’s 2025 guidelines for perioperative practice also found that lead garments have high contamination rates between 62.5% and 100%. As high-touch objects, it’s common for PPE to get exposed to harmful microorganisms during procedures that are tough to remove without proper cleaning practices.
AORN recommends quarterly deep cleaning for all high-touch objects in medical settings, like lead aprons, to keep all healthcare workers safe. It’s especially crucial for pregnant women who are supporting a developing fetus to avoid infections that would affect their health and well-being.
What Happens to Lead Aprons at the End of Their Lifecycle?
When lead aprons have defects that can’t be repaired, they will need to be removed from your inventory and disposed of properly. The EPA has strict regulations for lead garment disposal and recycling since lead can cause harm to environmental and human health as it decomposes.
Therefore, it’s important to use EPA-approved disposal practices that are designed to reduce those risks.
We know that hazardous waste disposal requires a lot of time and resources for healthcare facilities, so we offer services that help at RCS. Our garment disposal services handle many steps for you, including hazardous waste classification and containerization, EPA-certified transport, and detailed documentation of disposal processes used for compliance.
How Our Services at RCS Make a Difference
In addition to garment disposal, we offer other well-rounded services at RCS that can help you manage the entire garment lifecycle. Our services include:
Garment procurement from top manufacturers
Each of our services helps you operate more efficiently while following recommendations established by governing bodies such as the CDC, AORN, and the EPA to keep your garments maintained and protect your staff and patients.
Contact us today to learn more about how we can help at RCS.