Presented in 2014
Lead Apron Inspection Framework Study
Purpose
Inspection of Lead Aprons: A Practical Rejection Model
Over time, lead aprons and thyroid shields may develop defects, especially tears, potentially increasing the radiation dose to the wearer. Although annual inspections are required for X-ray garments by organizations such as The Joint Commission, there are no universal standards for when to reject aprons, requiring each facility to set its own criteria. The study aims to propose a practical model for routinely evaluating defects in lead aprons. The focus is on maintaining the annual radiation dose received by hospital personnel wearing lead aprons as low as reasonably achievable (ALARA).
To read the full study, click here.
Author:
M. Pillay
Author:
W. Stam
Findings Summary
Summary
Over time, lead aprons and thyroid shields may develop defects, particularly tears, which can increase the radiation dose to the wearer. The study introduces a model for assessing defects based on the concept of additional dose, which is the dose exceeding the expected level due to a tear in the apron. The model considers factors such as lead equivalence, tear size, and exposure geometry. Practical rejection criteria are established to guide periodic inspections, aiming to ensure radiation safety and adherence to ALARA principles.
The study recommends replacing aprons with defects exceeding 0.22 mSv, varying by the type of apron and location of tear (see table 2). An additional semiannual inspection is suggested for aprons with marginal defects.
A 10-month follow-up on aprons with small defects showed an average tear increase of over 270%. In a facility with 96 inspected lead aprons, 3.1% were found to have defects resulting in unacceptable additional doses. Comparisons with another facility suggest that the proposed rejection criteria do not lead to excessive rejection. Proper handling and storage are highlighted as crucial for maintaining the balance between economy and safety.
RCS Recommendation
The study suggests an annual inspection of lead aprons, emphasizing the importance of identifying and addressing defects promptly. Additionally, a semi-annual inspection is recommended for aprons with marginal defects to monitor potential progression.
The proposed rejection criteria, based on an additional effective dose of 0.22 mSv, provide a practical guide for determining the maximum tolerable tear length. The study encourages a balance between economic considerations and safety, advocating for proper handling and storage of lead aprons.
The rejection criteria, aligned with ALARA principles, serve as a valuable tool for quality assurance programs in medical facilities.
Based on the results of this study, RCS provides a complimentary annual inspection of all lead garments under contract to keep patients and staff safe by monitoring tears and cracks year after year. The X-ray images are tracked in RCS’s proprietary platform, RadComply, for customers to monitor, with guidance from RCS rejection criteria based on the original K. Lambert and T. McKeon study, “Inspection of Lead Aprons: Criteria of Rejection.”
$164,738 of Total Savings
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