Why Lead Aprons Need Professional Deep Cleaning, Not Just Wipes and Sprays
If you’re cleaning lead aprons with wipes and sprays alone, you could be leaving behind dangerous biofilm and other contaminants that can lead to infections and other risks for staff and patients.
My co-founder and I contracted Ringworm in two different hospital networks from wearing hospital-owned thyroid collars from facilities that had wipes-based protocols in place, so we knew that couldn’t be the right protocol.
We started RCS to develop a deep cleaning process that would protect clinicians and patients from hospital-acquired infections (HAIs) and raise awareness about the need for proper cleaning practices.
We’ll share here everything we’ve learned over the last decade from studying the effectiveness of wipes and sprays and when to use professional deep cleaning.
Recommended Protocols for Lead Garment Cleaning
From protecting clinicians during surgery or while administering X-rays to keeping patients safe during treatment, lead aprons are a high-touch object in the field.
Yet, even though organizations like The Center for Disease Control (CDC), The Joint Commission (TJC), and the Association of PeriOperative Registered Nurses (AORN) require other high-touch objects like door knobs, tray tables, keyboards, and light switches to be deep cleaned quarterly, X-ray garment cleaning protocols are left to manufacturers and healthcare networks to determine.
As high-touch objects, lead garments should be wiped daily and deep cleaned quarterly.
Daily use of wipes and sprays - specifically the ones listed in this article, since not all are made equally - can lightly disinfect your lead aprons and remove surface dirt and grime.
Unfortunately, wipes and sprays alone are not enough to properly remove biofilms and contaminants and should only be used in addition to deep cleaning of lead aprons.
Dr. Jaber from Wayne State conducted clinical studies revealing that X-ray aprons can harbor various microorganisms. In his research, Dr. Jaber cultured 25 lead aprons and found:
84% were colonized with Tinea species (Ringworm)
84% were colonized with Staphylococcus aureus
12% were colonized with MRSA
Deep cleaning your X-ray garments routinely, preferably quarterly, should involve a two-step cleaning and sanitization process that removes contaminants and biofilms, including Ringworm, Staph a, and MRSA, that wipes and sprays can miss.
This two-step cleaning and sanitization process is also recommended by governing bodies such as the TJC and CDC to keep patients and staff safer.
How to Use Wipes & Sprays Properly
Compare cleaning your lead garments with wipes and sprays to brushing your teeth. It helps maintain overall health, but you still need to visit a dentist at least twice a year. Think of professional deep cleaning like dentist visits for your lead aprons.
Wipes or sprays can surface clean your garments, but lead aprons still need deep cleaning to extend their lifetime and prevent the build-up of harmful bacteria like biofilm. Coincidentally, biofilm also makes up dental plaque.
Shortcomings of Wipes & Sprays Against Biofilms
Biofilm is an aggregate of microbes in which cells adhere to each other and the surface of lead garments. Biofilms can be single or multilayered, one or more species, and are often pathogenic in nature, creating a risk for hospital infections.
The National Institutes of Health disclosed that 65% of microbial infections and 80% of chronic infections are associated with biofilm formation.
Cleaning lead aprons using only wipes and sprays is likely spreading biofilms around the surface of the apron without fully removing them. Common disinfectants, meanwhile, can only remove the top layer of colonized bacteria, creating a feeding ground for the underlying bacteria and biofilm that ultimately increases the microorganisms on lead garments.
Dr. Kathleen Jones, a Doctorate in Emerging Infectious Diseases, explained, “When facilities only use wipes on a surface and don’t completely remove the debris, they are in essence creating an ‘all you can eat buffet’ for the surviving bacteria to thrive upon.”
A deep cleaning process like RCS uses eliminates biofilm on lead apron surfaces using a two-step process recommended by regulatory bodies to ensure the safety of clinicians and patients. The important aspect of deep cleaning for reducing biofilm is using friction, which needs to be done safely to not damage the garment. Without calculated friction, biofilm cannot be fully eradicated during the cleaning process and could be merely spread around on the surface of your apron if only wiped.
For example, a hospital in Ohio quietly cultured some garments before and after their first service with RCS. They were pleased to find that all 10 aprons showed no microorganism growth, confirming the effectiveness of our service and proper deep clean at removing colonized bacteria. – (The Diagnostic Imaging Manager offered to serve as a reference for anyone interested in discussing their findings further.)
Using wipes or sprays on X-ray garments is better than doing no cleaning at all, but ideally, these garments should be deep cleaned as part of a more robust system.
Compliance Challenges
Ensuring consistent and thorough use of wipes in sprays on lead aprons can be difficult, especially in busy healthcare environments.
An AORN study on garment cleaning regularity surveyed 173 healthcare workers, predominantly registered nurses in surgical settings, and discovered that:
78% reported wearing soiled protective gear
30.1% noted thyroid shield odors
48% admitted to never spot-cleaning
21.4% of aprons or shields never underwent standard department cleaning
X-ray wearables are often used in sterile environments and operating rooms and should be held to the same high standard of cleanliness as other high-touch objects.
A deep cleaning service will help ensure the compliance of your garment cleaning process. - (I share more on that below.)
How Wipes & Sprays Can Damage Lead Aprons
Certain chemicals in wipes and sprays, including alcohol and bleach, can degrade or oxidize the core material of lead aprons over time. This not only makes wearers more susceptible to germs and infections but can also compromise the integrity and efficacy of the garment.
Commonly used wipes and sprays also have specific requirements for effective use, like being used on a “pre-cleaned” or a “non-porous” surface. Additionally, those cleaning agents can spread biofilm on aprons and ultimately assist in its growth since they’re not properly eradicating and removing the biofilms, creating a false sense of safety.
Below are our recommended products that are safe to use daily for cleaning X-ray garments between deep cleanings.
How Deep Cleaning Works
It takes a two-step process of cleaning and sanitizing, as recommended by the CDC, to properly deep clean X-ray garments.
Cleaning – According to the CDC, cleaning involves using friction to physically remove dirt, microorganisms, and bioburden using EPA-registered products. The debris then must be removed or rinsed away from the surface. Though a significant amount of bioburden is removed during this process, the cleaning process does remove it all.
Sanitization – Sanitizing involves inactivating 99.9% of the remaining microorganisms on environmental surfaces. This is achieved by allowing the sanitizing agent to sit visibly wet or “dwell” on the surface for the recommended duration, as specified by the manufacturer’s instructions and guidelines.
RCS uses a proprietary two-step process. Our team begins with prepping the garments to be cleaned by removing debris from the Velcro and identifying areas that may need special attention. The garments are then cleaned and sanitized in a separate process. Part of our quality control program incorporates the use of ATP testing to help ensure best-practice outcomes.
Benefits of Deep Cleaning Lead Aprons
1. Increases the Lifespan
From sweat build-up after being worn on a long scheduled case to blood spatter in a trauma case, lead garments can get gross. We talk with clinicians regularly with horror stories about the condition of their lead aprons. Staff will also go to great lengths to ensure they’re getting the cleanest-looking and least-smelling lead garment, including hiding them in lockers and putting bike locks on them.
Smell, sweat build-up, and blood stains are all common reasons garments get replaced prematurely.
2. Greater Staff Satisfaction
Deep cleaning of your X-ray garments quarterly helps them smell better and look cleaner, in addition to keeping staff and patients safer. It also improves staff satisfaction because they’re no longer fighting for the cleanest garment and they feel good knowing that leadership invested in their safety.
This is a photo of a physician-owned thyroid collar we received for service. The physician was reluctant to send in his thyroid collar to get it cleaned because he was the only one wearing his lead. After his staff sent it in for him while he was on vacation, he was quite pleased with the results. Our team jokingly calls him “Dr. Peanut Butter”
3. Improved Compliance
Working with a professional deep cleaning service will help your team meet regulatory requirements and accreditation standards. Professional deep cleaning services use lead apron tagging for inventory management as well as keep other records and data that can be used for audits.
Why Choose RCS
RCS takes pride that our deep cleaning protocol is the most thorough in the industry. It comes from a place of wanting to do the right thing for clinicians and patients – I know what it’s like to get an HAI at work and I never want that to happen to anyone else.
We record all garment cleaning, repair, and integrity information year after year for our customers in RADCOMPLY™, our proprietary lead garment compliance and inventory management platform, so you always have access to your data and can easily export it for audits.
We also provide customers with sample protocol documentation to help simplify the implementation and onboarding process for teams. Many of our customers have received “best practice recognition” during their TJC audits on their lead garment management.
We also provide other services like emergency deep cleanings to help with issues like blood splatter as well as offer X-ray scanning and complementary repairs to give you peace of mind and prevent garments from being replaced prematurely.
Schedule Your Next Deep Cleaning
You can schedule a lead apron deep cleaning with RCS knowing we not only meet the standards, we set the standards as leaders in the industry for the past 10 years and the world’s first solution.
