Summary: Inspection of Lead Aprons: A Practical Rejection Model

Written By Justin McKay

This is a summary of the study “Inspection of Lead Aprons: A Practical Rejection Model” by W. Stam and M. Pillay. To read the full study, click here.

Purpose

The study aims to propose a practical model for evaluating defects in lead aprons on a routine basis. The focus is on maintaining the annual radiation dose received by hospital personnel wearing lead aprons as low as reasonably achievable (ALARA).

Summary

Over time, lead aprons and thyroid shields may develop defects, especially tears, potentially increasing 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.

Lead aprons in medical facilities are generally inspected annually, with an additional half-yearly inspection for those 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 proposed rejection criteria do not lead to excessive rejection.

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.

Justin McKay

Justin McKay is the Co-Founder and Vice President of Radiological Care Services (RCS), a leading provider of X-ray garment cleaning and sanitization solutions. With over 15 years of experience in the healthcare industry, Justin has a deep passion for patient and staff safety.

Driven by a personal experience with a hospital-acquired infection linked to contaminated X-ray garments in 2012, Justin co-founded RCS in 2013. Since then, he has spearheaded the company's growth, transforming it from a cleaning service into a comprehensive solutions platform that has helped over 500 departments in healthcare facilities across 42+ US States implement customized X-ray garment servicing programs. These programs have received best practice recognition from The Joint Commission, improved staff workflow efficiency, and reduced the risk for hospital-acquired infections (HAIs).

Before RCS, Justin held leadership positions in national sales at Ferris Mfg. Corp., a manufacturer of medical textiles. His experience wearing X-ray garments daily in the OR provided him with a first-hand understanding of the needs within healthcare.

Justin is a recognized expert in X-ray garment care and infection prevention. He is a frequent speaker at industry conferences and has been featured in publications like AHRA’s LINK for his innovative approach to X-ray garment sanitization. He leverages his expertise to collaborate with healthcare departments, developing customized programs that deliver value, consistency, and measurable outcomes. His commitment to building strong relationships has resulted in a network of satisfied clients across the United States.

Justin holds a bachelor's degree from DePauw University and a master's degree from Purdue University.

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