Lead Apron Inspection Checklist | Tips for X-ray Garment Care - RCS
Lead apron inspections should start as soon as you receive the garment, even before using it. Why is this necessary? Unfortunately, we occasionally find harmful damage when performing radiographic inspections on new pieces directly from the manufacturers.
Relying solely on palpation or visual inspections for lead apron safety is insufficient. Annual radiographic inspections are essential for identifying hidden damage. We recommend annual radiographic inspections, regardless of the regulations in your state.
This guide provides an inspection checklist to ensure your lead garments are correctly inspected and provide proper patient and staff safety measures.
What You’ll Need for an Inspection
Necessary tools and materials:
Garments to be inspected: Hang the aprons on apron racks or hangers.
Gloves: Nitrile or latex-style disposable gloves
Labels to record the date of inspection and any other related information
A way to document the results of the inspection: Some examples are pen and paper, spreadsheets, or software such as Apron Hub, Smart Track, and SmartID. These platforms require you to log in and update your garment records by hand. We enter this documentation information in our RADCOMPLY™ system for customers after each service, and you can also use the platform to store it to hold any additional information you need between services.
Inspection checklist: Create your own or use our downloadable version.
Trained staff to complete the inspections
Inspection Steps
Preparation
Gather materials (listed above).
Put on gloves.
Sanitize the surface you’re using for garment inspections.
Radiographic Inspection (Fluoroscopy or X-ray)
A radiographic inspection uses X-ray equipment to find otherwise undetectable damage in protective X-ray garments, such as micro holes. Radiographic inspection is a best practice measure recommended by garment manufacturing companies. RCS includes includes annual X-ray exams in our service contracts.
Fluoroscopy Inspection
Lay the apron flat on the fluoroscopy table.
Scan the garment using a low setting on the machine.
What to avoid:
A setting that is too high or too bright can damage an apron during a scan.
Do not use automatic brightness control, as it will increase tube current and high voltage, leading to unnecessary radiation exposure and wear on the tube.
Look for visible defects. Cracks or tears will show up as contrasting colors or lines. Holes will also be visible on the scan.
Record your findings, including the inspection date, who performed the inspection, and details on the garment’s condition.
Related research: Physicians K. Lambert and T. McKeon performed a study to establish stringent rejection criteria for lead aprons. Their findings suggest aprons should be replaced when defects exceed:
15 mm² when over critical organs (thyroid and gonads).
670 mm² when along the seams, in overlapped areas, or on the back.
11 mm² for thyroid shields.
X-ray Inspection
If fluoroscopic equipment is not available, an X-ray is a suitable alternative.
Lay the apron flat on the fluoroscopy table.
Take a radiograph of common areas for cracks and tears, including:
The waist of an apron, due to people sitting with a garment on, leading to cracks.
The chest or shoulders of an apron. The lead can pull away from the seams.
Process the image and look for breaks in the lead lining, typically appearing as dark slashes.
Record your findings, including the inspection date, who performed the inspection, and details on the garment’s condition.
Consult the measurements recommended by the Lambert and McKeon study listed above to determine the garment’s condition.
Visual Inspection
Check for apron defects that are visible to the naked eye while following these steps:
Perform inspections in a well-lit room with a large surface that can be easily sanitized between inspections, such as a table or a counter.
Carefully check for visible signs of damage, such as tears, cracks, or discoloration.
a. Aprons, mobile barriers, and other larger garments: we recommend checking from the top down on the front and the back.
b. Thyroid collars: check from left to right on the front and the back.
Inspect the seams of the apron and closures. Look for fraying at the seams, torn binding, broken buckles, worn velcro, and ripped hanging straps.
Record your findings, including the inspection date, who performed the inspection, and details on the condition of the garment.
As a reminder, we do not recommend relying solely on visual inspections for lead apron safety. Please do this inspection method in conjunction with annual radiographic examinations.
Palpation Inspection
To perform a palpation inspection, use your hands to feel the entire apron surface for any thinning of the lead, creases, cracks, lumps, sagging, or signs of separation at the seams.
Same as for visual inspections, use a well-lit room with a large surface, like a table or a counter.
Perform palpation inspections with the apron hanging on an apron rack. (This is easiest.)
While wearing gloves, run one hand along the front of the apron and one along the backside. Note any creases or cracks, uneven areas, or areas where the lead is pooling or gathering.
Test the closures, such as Velcro or buckles. closures
Record your findings, including the inspection date, who performed the inspections, and details on the condition of the garment.
As a reminder, we do not recommend relying solely on palpation inspections for lead apron safety. Please do this inspection method in conjunction with annual radiographic examinations.
Downloadable Inspection Checklist
Download our recommended inspection checklist to use during your next inspection.
Related Questions
How Do I Know if My Apron Passed Inspections?
Follow the measurement criteria established by the Lambert and McKeon study:
15 mm² when over critical organs (thyroid and gonads).
670 mm² when along the seams, in overlapped areas, or on the back.
11 mm² for thyroid shields.
How Do I Maintain or Repair Damaged Aprons?
Regular maintenance, such as inspections, repairs, deep cleaning, and sanitization, will help maintain aprons and extend their lifespan.
Aprons should be wiped down after each use with Clorox Hydrogen Peroxide Wipes or Ecolab Quaternary Based Wipes using the method outlined here.
Aprons should be deep cleaned quarterly.
Cosmetic repairs can be completed on the apron in areas without lead, such as straps, edges, or areas with Velcro.
Proper storage ensures aprons last longer, need fewer repairs, and avoid damage.
Aprons should be stored on heavy-duty racks or hangers hung by both shoulders. Aprons can be laid flat or rolled up like a beach towel when traveling. Do not fold aprons, as this will lead to large cracks in the lead.
How Often Should I Replace an Apron?
Based on our observations and studies, the average lifespan of a lead apron is typically five to six years, but it depends on many factors.
Protective Material: We've seen lightweight lead and lead-free aprons (thinner) last three to five years, whereas traditional lead aprons (thicker) last six to ten years.
Frequency of Use: Daily use of lead aprons requires more frequent replacement than occasional use.
Care and Storage: Proper cleaning, sanitization, and storage practices significantly extend an apron's lifespan.
What Records Should I Keep for Compliance?
Keep a record of your apron inventory, including your inspection results. Begin documenting this as soon as you receive the apron, even before using it.
This helps standardize and streamline your inventory process and ensures compliance with regulatory bodies like The Joint Commission. Having records as part of your inventory and inspection process makes this easy and ensures compliance.
RCS will record your inventory in RADCOMPLY™ after each service as part of our program. Your annual X-ray exams will be saved year-after-year and accessible via a QR code sewn onto the garment tag.
How Can I Train My Staff to Perform These Inspections?
Select a few trusted staff members to work on inspections in teams of two or three. Create your protocol for inspection and documentation and teach the dedicated staff members how to follow it properly. RCS can share sample protocols if you need them.
Having protocols in place will make training future staff members to conduct inspections easier and help maintain compliance by providing a standard.
Have regular refreshers on protocols, especially when any protocols are updated.
We also recommend outsourcing your inspections to save time and money. RCS includes annual X-ray inspections in our service to ensure the safety of all garments. The images are saved year-after-year in RADCOMPLY™ .
Key Takeaways and Next Steps
Regularly inspecting your X-ray garments helps prolong their life with proper care and attention.
We recommend annual radiographic inspections, regardless of the regulations in your state. Relying on palpation or visual inspections for lead apron safety is insufficient. Annual radiographic inspections are essential for identifying hidden damage.
Aprons can generally be repaired after cosmetic damage is found during an inspection, depending on the size and location of the damage.
At RCS, we offer complete X-ray garment care for lead apron cleaning, sanitization, repairs, radiographic scanning, inventory management support, old garment disposal, and new garment sourcing. Contact us today.
