Answer to Question #11434 Submitted to "Ask the Experts"

My grandmother, age 81, had her elbow x rayed in California. The x-ray technologist did not shield her. Does California have any laws about not shielding the elderly? I was able to watch this procedure through the technologist's window.

I am not familiar with x-ray regulations for the state of California, but I am familiar with those in some Midwestern states (Ohio, Kentucky, and Indiana). In those states, the only requirement for shielding patients during x-ray procedures is to shield the reproductive organs if those organs are going to be within the primary x-ray beam and are not in the way of what needs to be diagnosed. That simply means that the risk to the reproductive organs is not significant if they are not in the x-ray beam and if the x-ray technologist is following proper procedures (e.g., adjusting the size of the x-ray beam to fit just the area of clinical interest).

This is the same for the rest of the body during x-ray procedures and is due to the fact that the use of a lead apron for the patient normally does not provide significant protection from scattered radiation. In your grandmother's case, performing x rays on her elbow will not lead to significant radiation dose to other parts of her body. This tends to be the same for everyone, not just elderly patients.

Having said that, it is not uncommon for facilities to provide lead aprons to cover parts of their patients that are not x rayed during procedures (in addition to reproductive organs). Although a lead shield typically does not reduce doses significantly as discussed above, it does provide peace of mind to the patient, and many times, to the x-ray staff.

When asked this question by the facilities that I work for, I give them the information above: I tell them that it is okay to provide a lead apron in these cases, but it is not required.

Kennith "Duke" Lovins, CHP