Answer to Question #1856 Submitted to "Ask the Experts"

Q

Where would I find information regarding state regulations for radiation protective garments, such as a lead apron? Is this a state regulated item? Does the FDA set the guidelines?

A

Regulations vary from state to state regarding protective garments such as lead aprons. Since a particular state was not specified in your question, a list of contacts for each state radiation control program can be found at the Conference of Radiation Control Program Directors Web site. For example, Ohio, Kentucky, and Indiana all have similar requirements for possession and use of lead aprons for gonadal shielding and for shielding of individuals present in radiographic and fluoroscopy rooms. However, details and thickness requirements vary from state to state, and none of the states mentioned above list requirements for testing intervals of protective garments. Information on lead aprons and recommendations for testing them are given below.

Ken "Duke" Lovins, MS, CHP

Lead Apron Inspection
Lead aprons are used in medical facilities to protect workers and patients from unnecessary radiation exposure from diagnostic radiology procedures. Due to standards set forth by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), healthcare organizations must perform inspections on medical equipment, including lead aprons. The JCAHO standard does not dictate inspection frequency, method, or rejection criteria. This allows facilities to develop their own policies and procedures to evaluate their lead aprons. Typically, a facility will perform an inspection of each apron on an annual basis. Some facilities choose to survey their aprons on a more frequent basis, such as every six months. This may be recommended if aprons are heavily used and/or are not always properly stored after use (folded or piled up instead of placed on a hanger). The inspection consists of a visual check to look for obvious tears, cuts, or rips, etc. and a check using x-rays to verify the shielding integrity of the apron. For facilities that have fluoroscopy, the apron is placed on the table and checked using the automatic brightness control. This is usually a fairly simple procedure since the equipment will adjust itself to "see through" the apron. Using fluoroscopy, defects such as pinholes, cracks, and tears show up as very bright (white) areas. If fluoroscopy is not available, then a radiographic unit may be used to x-ray the apron one section at a time. In this method, a film cassette is placed under a part of the apron and an appropriate exposure is made and the film is examined for defects in the apron. On film, defects show up as very dark areas. For either method, try x-raying over the seams to see the rows of pinholes caused by sewing the edge onto the apron. This will show that holes, etc., that go all the way through the apron will be very obvious (due to the extreme contrast seen). There are two recent articles that address lead aprons (referenced below). One addresses implementing an inspection program and includes techniques for testing aprons, and the other proposes a rejection criteria based on effective dose equivalent (essentially, whole-body dose based on dose to various critical organs).

References

 

• Michel R, Zorn MJ. Implementation of an x-ray radiation protective equipment inspection program. Operational Radiation Safety 82(2): S51-S53; 2002.
   
• Lambert K, McKeon T. Inspection of lead aprons: Criteria for rejection. Operational Radiation Safety 80(5): S67-S69; 2001.