How Thick Should a Thyroid Shield Be?
Radiology and interventional surgery procedures using X-rays, C-arms, and fluoroscopy emit harmful scatter radiation that can negatively affect sensitive organs like the thyroid gland.
A thyroid shield that wraps around the neck is often recommended to protect that sensitive organ in high-dose environments. It’s especially crucial in surgical procedures using C-arm guided fluoroscopy, where the clinician’s neck may be directly exposed to the radiation source from leaning over the patient while operating.
However, you’ll notice that thyroid shield covers come in different thicknesses. Which thickness is best for optimal protection? We’ll cover what you should know in this guide to make an informed decision.
What Is the Thickness of a Thyroid Shield That Should Be Worn During Fluoroscopy?
A study published in the Korean Journal of Pain recommended clinicians use a thyroid shield thickness of at least 0.5 mm during fluoroscopy. The study suggested that a 0.5 mm thyroid shield can reduce the ionizing radiation dose received by up to 2.5 times.
Other Best Practices for Thyroid Shielding
The shield’s thickness isn’t the only element you must pay attention to for protection in high-dose procedures.
A study published in 2013 found that a properly fitted thyroid shield provides significantly better protection. Researchers compared a traditional lead thyroid shield worn securely against one worn loosely during C-arm guided fluoroscopy. The results revealed that the well-fitted shield reduced radiation exposure by an additional 19%.
The snug lead thyroid shield reduced the overall radiation dose to the thyroid gland by 8.5 times. Therefore, this study provided even better thyroid protection results than the previous one from the Korean Journal of Pain.
Additionally, the study assessed the use of radiation protective garments with a bismuth masking agent applied on top and found that those shields reduced the radiation dose even more. However, more research on bismuth masking agents is necessary to confirm that finding.
How Thick Should a Lead Apron Be?
Personal protective equipment (PPE) like lead aprons are another crucial radiation protection measure. They hang from the shoulders down to just above the knees to shield crucial organs like the breasts, lungs, heart, and gonads.
A study in the Journal of Clinical Orthopedic Trauma recommended a lead apron thickness of 0.5 mm. The research showed that a 0.5 mm lead apron could attenuate up to 99% of the radiation dose received.
What Thickness Equivalence is Required for Thyroid Shielding?
Lead thickness equivalence requirements can vary by procedure. For instance, traditional medical X-rays emit lower doses of radiation than procedures like C-arm-guided fluoroscopy. AORN states that the average C-arm emits a radiation dose of 2 rem (20 mSv) per minute. In contrast, the American Cancer Society states that the average chest X-ray emits 0.1 mSv per image, and the average mammogram emits 0.4 mSv.
Clinicians conducting regular X-rays should still wear thyroid shielding since even low doses add up over time. However, they may be able to get away with lighter thicknesses, depending on the procedure. A study from the Journal of Radiation Physics and Chemistry stated that lead thyroid collars for X-rays should be 0.25-0.5 mm thick to provide sufficient protection.
Conclusion: Ensuring Optimal Thyroid Protection
Thyroid shielding is essential for radiation safety in procedures involving X-rays, C-arms, and fluoroscopy.
The research shows that 0.5 mm thyroid shields are effective for most high-dose procedures, and clinicians may be able to get away with lighter shielding in lower-dose X-rays. Therefore, it’s best to consult with your facility’s radiation safety officer to choose the proper shielding and thickness for each procedure and minimize health risks to sensitive organs like the thyroid.
Other Ways to Ensure Your Protective Garments Perform at Their Best
Having clinicians wear proper shielding isn’t the only thing medical facilities must worry about. It’s also important to keep protective garments cleaned, inspected, and maintained so they’re as safe and effective as possible.
We recommend annual inspections using X-ray scanning for protective garments like lead aprons and thyroid shields. These garments can accumulate cracks, holes, and tears with regular use that must be identified and repaired to ensure they’re as effective as possible. A study in the Journal of Health Physics showed that even small tears can progress rapidly, increasing by up to 270% in 10 months.
Additionally, governing bodies like AORN recommend quarterly deep cleaning and disinfection for high-touch objects like lead aprons and thyroid collars. A study by Dr. Jaber, who assessed 25 lead aprons, found that 84% were contaminated with Staphylococcus aureus and Tinea species (ringworm), and 12% were contaminated with MRSA. Proper deep cleaning is necessary to remove those tough microorganisms.
How We Can Help at RCS
At Radiological Care Services (RCS), we provide services that help you keep your protective garments clean, maintained, and effective. Our services include:
Deep cleaning and disinfection
Annual inspections with X-ray scanning
Garment disposal
Garment repairs
Inventory management with our RADCOMPLY™ software
Our services follow recommendations from governing bodies like AORN and the CDC to ensure all protective garments are properly cleaned for staff and patient safety. We also emphasize the importance of protecting vulnerable areas like the thyroid to reduce the risk of thyroid cancer from occupational radiation exposure.
We’re here to make protective garment cleaning and maintenance efficient and effective. Contact us today to learn more about how RCS can help.