Protective Material Guide
Healthcare workers in radiology are frequently exposed to radiation during diagnostic imaging and interventional surgery using equipment like X-rays, C-arms, and fluoroscopy. This exposure risk also extends to staff working in nuclear medicine suites who handle radioactive tracers daily.
As a result, governing bodies like the CDC and OSHA recommend wearing personal protective equipment (PPE) as one of the essential protective measures for radiation safety in healthcare. Provide personal protective equipment policies ensure clinicians enter every case with garments that meet current shielding standards.
While researching protective garments like aprons and thyroid collars, you’ll see they’re available in varying materials and thicknesses. It’s common to feel confused about the best protective materials for safety and effectiveness, and wonder where to start. Budget-conscious departments often search for low cost options that still satisfy regulatory requirements.
We’re here to help. In this guide, we’ll review why PPE is necessary, the most effective materials, and how different options compare based on current clinical research. Read on for all the details. Our goal is to equip employees with practical training that simplifies purchasing decisions.
Introduction To Radiation Protective Clothing And Equipment
The World Health Organization (WHO) mentions several negative health effects that can result from frequent occupational exposure to radiation in medical settings. That includes an increased risk of cataracts, cancer, infertility, and skin and blood damage. Recognizing these hazards early is critical to protect staff and patients alike.
Fortunately, X-ray protection equipment like lead aprons, thyroid shields, and glasses can help reduce exposure substantially. Radiation protective clothing is often made from heavy metals such as lead. The benefit of a material like lead is that it has a high density that slows and absorbs X-rays and gamma radiation before they reach the wearer’s body.
Several clinical trials show that these protective garments are highly effective at reducing radiation exposure:
Research published in the Journal of Clinical Orthopedic Trauma shows that 0.5 mm lead aprons can attenuate up to 99% of radiation.
A study published in the Korean Journal of Pain states that 0.5-0.75 mm thyroid shields can reduce radiation doses by 95%.
A study from Physica Medica found that 0.75 mm lead glasses could reduce doses to the eyes by 1.6 times, and a full lead visor could reduce doses by 4.5 times.
Lead is a common and time-tested material for shielding that has been used for decades. However, it’s not the only option available when looking for PPE. You’ll also see several alternative materials while reviewing protective material guide PDFs and options from different manufacturers.
What Are the Main Types Of Materials Used In Radiation Protective Clothing?
When researching materials for radiation protection, you’ll frequently see lead, lightweight lead, and lead-free options listed on manufacturer websites.
Traditional Lead
As mentioned, traditional lead is the time-tested option and has proven effectiveness in many clinical trials across different types of garments. However, the main problem with traditional lead garments is their weight. A study in 2022 showed that the weight of lead aprons could cause physical strain, fatigue, and joint stress for clinicians wearing them for extended amounts of time.
To help offset those effects, many manufacturers are working toward developing lighter-weight options that still have high protective capabilities.
Lead-Free Options
One of those options is lead-free alternatives. A study from the Journal of Biomedical Physics and Engineering lists several alternative materials to traditional lead that can be used to shield against radiation. Those include:
Bismuth
Barium
Tungsten
Tin
Antimony
Each of these heavy metals still has a high density to slow and absorb radiation while generally being lighter than traditional lead. A study in the Journal of Radiation Physics and Chemistry found that lead-free aprons made of barium and tungsten are approximately 13-25% lighter than traditional lead aprons while attenuating radiation at a similar level.
Another study from the European Journal of Radiology showed that lead-free aprons perform similarly to traditional lead aprons at lower intensities below 90 kVp, but traditional lead aprons performed a bit better at intensities above 90 kVp. Therefore, the intensity of the procedure could determine whether lead or lead-free PPE is the better choice.
It’s important to review manufacturer testing data and consult with your facility’s radiation safety officer to determine the best options for each procedure.
Lightweight Lead
Lightweight lead garments are made from composites that combine lead and lighter materials like tungsten, tin, antimony, bismuth, and barium. The result is an overall lighter garment that’s still made of dense heavy metals to shield the wearer from radiation.
The study mentioned before from the European Journal of Radiology also evaluated lightweight lead aprons and found similar results to lead-free options. Lightweight lead performed similarly to traditional lead at voltages below 90 kVp, but traditional lead performed slightly better at voltages above 90 kVp.
How Do Lead, Lightweight Lead, And Lead-Free X-Ray Protection Compare?
In addition to the weight and protective capabilities of these different materials, there are still some other considerations to make in this comparison. Those include:
Cost
Lightweight lead and lead-free options typically cost more than traditional lead. For example, a 0.5 mm traditional lead wraparound apron from Burlington Medical costs an average of $612, whereas their 0.5 mm lightweight options cost between $860 and $935.
Therefore, it’s important to consider the costs involved when budgeting for X-ray protection equipment and deciding what works best for your facility.
Durability
Traditional lead aprons are usually thicker, which makes them more durable and gives them a longer average lifespan. Studies, such as one from the Journal of Anesthesia, often state that traditional lead aprons last 5-6 years and can last longer when properly stored and maintained. Alternatively, lightweight lead and lead-free aprons often last 3-5 years.
Environmental Impact
Lead-free garments are easier to dispose of responsibly. Facilities may opt for non hazardous disposal services to simplify compliance. Therefore, they could alleviate some constraints at the end of garment lifespans.
However, there are still options to safely and efficiently dispose of lead garments. We can help with garment disposal at RCS to simplify the process while following all regulations from the EPA and other governing bodies.
How Do You Choose The Right Thickness And Style For Radiation Vest Protection?
Another consideration is the lead equivalence (or thickness) of PPE.
The most common are 0.25 mm, 0.35 mm, and 0.5 mm thicknesses in lead aprons. The International Atomic Energy Agency (IAEA) recommends at least 0.25 mm lead equivalence for low-intensity imaging and a 0.5 mm lead equivalence for higher intensity procedures.
Some thicker options (up to 1.0 mm) may be used for extra protection, such as in maternity lead aprons.
Apron And Vest Styles
Lead aprons can also come in different styles.
Two common choices are full frontal lead aprons and wraparound aprons. The Journal of Radiation Protection Dosimetry recommends frontal coverage for simple procedures where clinicians face the radiation source the majority of the time, and wraparound aprons if clinicians often turn their backs to the radiation source.
You may also see two-piece vest and skirt sets. The radiation vest protection covers the torso, while the skirt covers the upper legs and reproductive organs.
Two-piece protection is an alternative to full aprons that reduces the amount of weight hanging from the shoulders. A study from PLOS One showed that two-piece PPE effectively reduced weight pressure and shoulder fatigue.
What Standards And Inspections Ensure The Effectiveness Of Radiation Protective Clothing?
Several quality control measures and integrity inspections are performed to ensure the protective clothing produced for use in medical facilities performs as intended.
The International Electrotechnical Commission (IEC) is an organization that sets standards for electrical and technical equipment, including protective clothing and eyewear used in medical facilities. Under IEC 61331 parts 1 & 3, they set radiation protective clothing standards for sizing, design features, and minimum attenuation properties.
The American Society for Testing and Materials (ASTM) is another organization that sets standards for a wide range of materials and products. Under ASTM F2547 part 18, they set standards for testing PPE, such as requiring manufacturers to test them at intensities of 60 and 130 kVp to ensure they meet attenuation requirements.
How Should X-Ray Protection Equipment Be Cared For And Maintained?
Radiation protective clothing maintenance is essential to ensure your PPE remains as effective as possible throughout its lifespan. Maintaining your protective garments includes regular deep cleaning and disinfection, inspections, and making necessary repairs.
Cleaning Needs For Protective Garments
AORN’s 2025 guidelines for perioperative practice stress that PPE like lead aprons, thyroid shields, vests, and skirts show some of the highest contamination levels between 62.5% and 100% in medical settings. As a result, AORN recommends regularly cleaning PPE before and after use for essential infection control that reduces the buildup of dirt, germs, and bacteria.
To perform daily X-ray protection equipment cleaning, lay garments flat and wipe them down with a disposable microfiber cloth. We recommend using either Clorox Hydrogen Peroxide Wipes or Ecolab Quaternary Based Wipes, which apply friction to align with the CDC’s cleaning recommendations.
Additionally, AORN recommends quarterly deep cleaning for all high-touch objects in medical settings to remove tough bioburden that can’t be removed by wipes and sprays alone.
We can help with quarterly deep cleaning and disinfection at RCS. We use a detailed process that includes applying garment-safe, EPA-approved cleaning products using friction, followed by a disinfecting agent, and ATP testing to ensure all microorganisms are removed.
Inspection Needs For Protective Garments
It’s common for PPE worn in medical settings to accumulate wear over time. The problem is that damage like cracks, holes, or tears that go unnoticed can affect a garment’s fit and protective capabilities.
We recommend performing annual radiographic inspections to locate damage early and get it repaired. A study in 2018 showed that regular radiographic scans for protective garments were the best way to identify minor damage that isn’t always visible.
Lead apron inspections aren’t something you should neglect. A study from the Journal of Health Physics found that even small tears can progress rapidly, increasing by up to 270% in 10 months.
You can also perform visual and tactile inspections in addition to annual X-ray inspections. Those involve laying garments out flat and looking or feeling across their surface for any noticeable cracks, holes, tears, fraying, or damage to buckles and velcro.
Visual and tactile inspections don’t replace deeper X-ray scans, but they can help find anything that requires immediate attention.
How We Can Help Keep Your Protective Garments Maintained At RCS
While performing routine cleaning and inspections on protective garments is crucial, we know busy medical facilities can struggle to keep up with all the maintenance needs. We can help make the process easier at Radiological Care Services (RCS).
Our services include:
We’ll work with you to develop an efficient and effective process that follows regulations from governing bodies like AORN and the CDC.
Contact us today to learn more about how RCS can help keep your PPE in top condition.