Occupational radiation exposure should be a concern for healthcare facilities and staff members due to radiation emitted from equipment such as X-rays, C-arms, and fluoroscopy. Frequent exposure to ionizing radiation emitted during diagnostic or interventional procedures in radiology can lead to many negative health effects, making protection vital.
Personal protective equipment (PPE) for radiation protection, such as lead aprons, thyroid collars, or glasses, is a common form of protection that helps reduce radiation exposure substantially. However, healthcare facilities can encounter problems getting staff members to use it.
Why don’t healthcare workers always use PPE if it’s so important and effective? Many issues can lead to a lack of compliance with radiation safety standards involving PPE, such as discomfort, fatigue, lack of maintenance, or not having enough protective garments available in the facility.
In the rest of this guide, we’ll provide you with information to help uncover where a medical facility’s problems with radiation protection compliance may be coming from and tips to improve processes for better results. Read on for all the information.
Why Healthcare Workers Skip Radiation Protection Equipment
A good place to begin this discussion is reviewing the most common barriers to wearing lead aprons and other PPE.
What Are the Main Barriers To Wearing Lead Aprons?
Some of the main findings across clinical trials that often prevent the use of protective equipment include:
Weight and Fatigue
Research published in the Korean Journal of Pain stated that the average weight of a lead apron is 7 kg (approximately 15 lbs). That’s a substantial amount of weight for clinicians to have hanging from their shoulders during extended procedures or throughout long shifts.
A study in PLOS One found that weight pressure on the shoulders is a common cause of fatigue and physical strain during use, and can make clinicians less likely to want to wear lead aprons during procedures.
Fortunately, alternative options are available that can reduce this constraint. The study in PLOS One found that switching to two-piece lead vest and skirt sets helped reduce weight pressure and physical strain. A two-piece set helps distribute the weight between the shoulders and the waist, so clinicians still get the benefits of lead shielding without as much accumulated fatigue.
A study in the Journal of Clinical Orthopedic Trauma stated that two-piece protection is just as effective as one-piece lead aprons, attenuating up to 99% of radiation, so it provides a good alternative when weight and fatigue are a concern.
Reduced Mobility
Another study from the Journal of Radiation Research and Applied Sciences found that reduced mobility while wearing lead aprons is another common concern for healthcare workers, alongside weight pressure and fatigue. Not being able to bend or reach effectively could interfere with procedures, causing clinicians to stop wearing protective garments.
The study found that one of the primary reasons why complaints about mobility happen is that the garments clinicians are wearing don’t fit correctly. Garments that are too snug may restrict movement, whereas garments that are too big could shift too much and discourage movement.
In addition to proper fit, researchers mentioned that using lead aprons with better ergonomic designs also helps improve mobility and comfort. Therefore, it’s important to procure garments from high-quality manufacturers producing ergonomic designs as well as ensuring they fit each clinician correctly.
Lack of Proper Cleaning and Maintenance
A study published in AORN, where researchers surveyed 173 healthcare workers, also found that many report a lack of maintenance for protective garments like lead aprons. The study found that:
- 78% of healthcare workers report wearing soiled protective garments
- 48% admitted to never spot cleaning PPE
- 30.1% reported thyroid shield odors
- 21.4% said that lead aprons and thyroid shields never underwent standard department cleaning
When PPE is soiled, has odors, or clinicians know that it rarely undergoes cleaning, it reduces morale and discourages the use of radiation protection equipment during procedures. Therefore, it’s important to keep PPE maintained throughout its lifespan to ensure ongoing use and the health and safety of staff members and patients.
Why Is It Important for Healthcare Workers To Wear Personal Protective Equipment?
Governing bodies, such as OSHA, have established radiation dose limits that healthcare workers must remain under for health and safety. OSHA’s dose limit for the whole body is 1.25 rem (12.5 mSv) per quarter.
The World Health Organization (WHO) states that when healthcare workers exceed dose limits established by governing bodies like OSHA, it can lead to many adverse health effects. Common health risks of radiation exposure without protection include cancer, cataracts, blood damage, skin damage, and infertility.
Therefore, using proper shielding and radiation safety techniques to reduce radiation doses as much as possible is essential for health and safety.
How Can Healthcare Workers Reduce Exposure to Radiation?
Several radiation protection measures are available to help healthcare professionals reduce radiation exposure. Here’s an overview of the common safety measures and precautions facilities can take to help.
What Radiation Safety Precautions Minimize Occupational Radiation Exposure?
The most effective way to reduce occupational exposure to radiation is to follow the principles of ALARA (as low as reasonably achievable) outlined by the CDC and other governing bodies. ALARA includes three steps that can help reduce exposure during medical procedures involving radiation:
- Time: The less time healthcare workers are exposed to radiation, the lower the dose received. The CDC states that completing work efficiently and leaving the area as soon as possible can help. However, some procedures require extended durations of exposure, so reducing exposure time isn’t always possible.
- Distance: Increasing the distance from the radiation source reduces doses received. AORN recommends remaining at least six feet from equipment emitting radiation when possible. However, some procedures require physicians to operate right next to a fluoroscopy tube, C-arm, or other radiation source.
- Shielding: Use shielding such as lead aprons, vests, skirts, thyroid collars, glasses, or mobile barriers to minimize exposure. When it isn’t possible to reduce time or distance, wearing protective garments is a crucial safety measure that can help. It’s a big reason why compliance with radiation safety standards involving PPE is so important.
How Does Radiation Safety Training Improve Radiation Protection Knowledge?
Another study published in March of 2024 found that a significant percentage of healthcare workers surveyed showed low knowledge of common radiation safety standards and considerations, likely due to poor training. A lack of training can also lead to poor safety compliance and not using PPE.
A study published by Ecancer Medical Science stressed the importance of radiation safety training for all new healthcare staff members. The facility’s radiation safety officer (RSO) should play a crucial role in establishing the safety program and ensuring all new staff members complete it during training.
What Should Be Done To Keep Healthcare Workers Safe From Radiation?
Facilities can help reduce the amount of radiation healthcare workers are exposed to by establishing a radiation protection program, ensuring enough PPE for radiation is available, and keeping it well-maintained throughout its lifespan.
How Do Radiation Protection Programs Create a Radiation Safety Culture?
The International Radiation Protection Association (IRPA) states that establishing a strong radiation safety culture requires:
- Strong leadership
- Education and training
- Establishing positive behavior in the workplace
- Proper communication with everyone involved
A radiation protection program helps build a radiation safety culture because it establishes clear guidelines throughout the facility that healthcare workers and managers must follow. It shows that radiation safety is a priority and helps encourage the use of protective measures like wearing PPE for shielding.
Why Does Equipment Availability and Maintenance Matter for Occupational Radiation Protection?
In addition to training and establishing a strong radiation safety culture, it’s essential to ensure protective garments are readily available and well-maintained.
As mentioned, lead apron cleaning and disinfection are crucial since soiled garments can discourage the use of PPE. Contaminated lead aprons are also a health hazard, because harmful microorganisms accumulated in medical settings can lead to high rates of hospital-acquired infections.
A study conducted by Dr. Jaber of Wayne State found that 84% of lead aprons analyzed were contaminated with Staphylococcus aureus and Tinea species (ringworm). Governing bodies, such as AORN, recommend quarterly deep cleaning for all high-touch objects in medical facilities, including lead aprons, to prevent the buildup of harmful contaminants.
Additionally, protective garments should be regularly inspected for damage, such as cracks, holes, or tears that can affect how they fit or reduce their effectiveness. A study published in the Journal of Health Physics found that small tears in lead aprons could increase by up to 270% in 10 months, so identifying damage early is essential. We recommend annual inspections using X-ray scanning to help with this.
How To Keep Healthcare Workers Safe From Ionizing Radiation With Professional Services
Busy medical facilities can struggle to keep up with maintenance and sourcing needs for protective garments like lead aprons and thyroid shields. That’s why we offer solutions that can help at RadCare Services (RCS).
We work with high-quality manufacturers and partner with facilities to help source high-quality PPE for radiation protection.
We also offer several maintenance and lifecycle management services, including:
- Deep cleaning and disinfection
- Inspections using X-ray scanning
- Garment repairs
- Garment disposal
- Inventory management with our RadComply® software
Each of our services follows guidelines established by governing bodies, such as the CDC, EPA, and AORN, to ensure effective and compliant results.
Want to learn more about how our services can help? Contact us today to see how RCS can make a difference for your facility.
