Why Hospitals are no longer using lead aprons during x-rays

March 13, 2020 0 Comments

For both patient and radiologist, using lead blankets (or aprons) during an x-ray has been commonplace since the 1950s. But with some American hospitals now foregoing lead protection, how safe is it really?

Hospitals and lead aprons during X-rays 

Prominent medical and scientific groups in the US, including the American College of Radiology, have proposed that lead protection is merely a “feel-good” measure, which could actually be hindering tests and “inadvertently increase a patient’s radiation exposure”.

“There’s this big psychological component, not only with patients but with staff… How do you approach something that is so deeply ingrained in the minds of the health care community and the minds of patients?” argued Rebecca Marsh, a medical physicist at the University of Colorado while speaking at the annual meeting of the Radiological Society of North America.

Lead shields have been used since the 1950s as a way to cover testicles and ovaries after preliminary studies in fruit flies caused concern that radiation might damage human DNA and cause birth defects. However, medical specialists now believe that the use of lead shields inadvertently obscure areas of the body required to be seen, particularly when the treatment area is located close to organs.

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The biggest concern for radiologists is the “scatter”, which occurs when the radiation ricochets inside the body, underneath the shield, where the energy is deposited into the patient’s tissue. However, this does not account for the scatter that reaches the radiologist administering the radiation.

A study completed in South Korea in 2016, looked at how vital it was for radiographers to wear lead aprons. The study found that while the lead apron was beneficial, it only blocked just over one third of the radiation scattered towards the surgeon. However, their conclusion was less directed towards whether the radiologist should be wearing a lead apron or not, but into more effective ways of reducing radiation exposure.

The study concluded that “reduced radiation use (e.g. by using robotic guidance) is a more effective strategy for minimising exposure to radiation than reliance on protection by lead aprons, and recommend utilisation of practices and technologies that reduce the surgical team’s routine exposure to x-rays.”

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For radiologists, these precautions are justifiable due to their regular contact with radiation. However, as these new procedures are being presented without short or long-term research and merely educated conjecture, it is difficult to ascertain whether laws should change to allow or disallow this change. Particularly if the practice is deemed as a “feel good” measure, the only way to ultimately overturn this is with indisputable evidence that proves or disproves the need for a lead blanket during radiation therapy.

Would you forgo using a lead blanket on the basis of these claims? Or do you think a research study is required to understand the short-term and long-term risks of no longer providing patients with a lead blanket? We would love to hear your thoughts!


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