Lead Rubber Apron Research Articles

An Assessment of the Lead rubber aprons in Radiodiagnostic centres in South-South Nigeria

Background of Study: Radiation protection is of core importance in radiodiagnostic centres, to keep both patients care givers and staff of the centres from stochastic and non- stochastic effects of radiation. The effectiveness and protectiveness of aprons are of valuable importance, it is therefore necessary to assess these aprons to ensure efficacy. Such quality checks have not been reported in the South – South region of Nigeria. Aim: To assess in terms of their quality and therefore protective features, the lead aprons in used radiology clinics in the South-South region of Nigeria. Method: Twenty two protective lead aprons from 18 radiological clinics in South-South Nigeria were directly exposed to X-rays with average factors of 70 ± 5kVp, 16 mAs and 100 cm Source to apron distance, with 43 x 35 cm cassettes places underneath to cover the upper (thoracic half) and the lower (abdominal half) respectively. Exposed films were processed in each centre following regular processing protocols to obtain radiographs with images of the state of the aprons. The images were analyzed on the basis of each apron’s lead equivalence (content), age, brand and the type of defects observed. Defects were characterized into cracks, tears, splits and rips. Physical examination for cleanliness, wear and tear was also carried out. Results: Results showed that 68% of all the aprons under study were defective, having cracks (44%), tears (33%), splits (15%) and/or rips (8%). About 73 % of the defective aprons had more than one (1) type of defect. Up to 87% of the defective aprons had no inherent lead equivalence and manufacturer identification indicated on them. It was observed that about 73% of these defects occurred in aprons of aged between 1-10 years with the area affected in the range of 1.00 – 1000.00 mm2 . Conclusion: Over two-thirds (⅔) of lead aprons found in diagnostic radiology centres in South – South Nigeria, have shown sufficient evidence of defects to suggest that they may not be useful for radiation protection of the users.

Investigation of radiation protection and safety measures in Rwandan public hospitals: Readiness for the implementation of the new regulations

BackgroundAn essential concept that all radiographers are required to implement is the use of techniques and the provision of protective devices to minimize radiation to patients and staff. Methods to achieve this could include good communication, immobilization, beam limitation, justification for radiation exposure, shielding, appropriate distances and optimum radiographic exposures factors. PurposeThe aim of this study was to assess the availability and utilization of radiation protection and safety measures by medical imaging technologists (MITs) in Rwandan hospitals. MethodsA quantitative, non-experimental descriptive design was used and data collected by means of a self-designed questionnaire. One hundred and sixteen MITs (n = 116) representing 96.67% of the total population participated in the study. ResultsThe study found radiation safety measures were not adequately implemented in government hospitals. Only 58.62% of MITs had radiation-measuring devices, with 29% receiving dose readings inconsistently. Lead rubber aprons were available at 99.13% of the hospitals; however, 59% of the participants had never checked the integrity of the aprons. Lead rubber aprons and lead equivalent barriers were most prevalent in the facilities. ConclusionThe study found there was a lack of adequate radiation safety equipment. Exposure charts and immobilization devices were not adequately implemented in the hospitals. The level of education and experience of the MITs did not appear to influence the radiation safety practice significantly. There is a need for concerted efforts between the Rwanda Utilities Regulatory Authority (RURA), Ministry of Health, University of Rwanda and hospital management to improve the radiation safety culture, especially in view of the law governing radiation protection that was recently promulgated.

How effective are lead-rubber aprons in protecting radiosensitive organs from secondary ionizing radiation?

IntroductionThe purpose of this experiment was to explore the direction of scattered secondary ionizing radiation to a patient. A left lateral radiographic examination of the elbow was deemed appropriate due to its close proximity to radiosensitive organs and record dose limiting opportunities upon wearing a lead-rubber apron. MethodsAn anthropomorphic phantom and lead-rubber apron (Pb 0.35 mm) was used with a 15 cc ionization chamber (model 10,100 AT TRIAD) to measure scattered radiation to radiosensitive organs. Dose readings were recorded before and after in order to quantify dose reduction. Pearson's correlation, linear regression, t-test and one way analysis of variance (ANOVA) statistics were used to affirm how likely dose limitation was attributed to chance (p < 0.05). ResultsThe lead-rubber apron offered dose reduction to most radiosensitive organs. Notably, ionizing radiation was significantly reduced to the left breast 0.0083 μGy (98%), right breast 0.0000 μGy (99.9%) and spleen 0.0262 μGy (99.9%). No empirical benefit was recorded for testes and ovaries. Interestingly, the thyroid recorded an increase in dose (0.1733 μGy; p = 0.01). This was later mitigated using a thyroid collar but identifies increased stochastic risks if lead-aprons are worn alone. Scattered radiation was also reduced to both eyes, which were not directly covered. ConclusionLead-rubber aprons are generally utilized to limit ionizing radiation, yet this article offers insight whereby increases to ionizing radiation to the thyroid are plausible when wearing a lead-rubber apron alone. Whilst these findings cannot be generalized to other radiographic examinations it provides insight into a potential increase risk of scatter to a radiosensitive organ. Implications for practiceThis paper has implications because it identifies that lead-rubber has an impact on scattered ionizing radiation to radiosensitive organs for a lateral elbow examination. Further, it identifies the potential for ionizing radiation to be increased to the thyroid upon wearing a lead-rubber apron alone.

Are Antimony-Bismuth Aprons as Efficient as Lead Rubber Aprons in Providing Shielding against Scattered Radiation?

AimThe aim of this study is to compare the absorption ability of two lead-free aprons with a lead apron. MethodThe absorption ability of three aprons was measured and compared; Opaque Fusion 0.35 mm (OpaqFu) bilayer apron containing bismuth and antimony, No Lead 0.35 mm (NoLead) one-layer apron containing antimony, and a lead apron. The measurements were repeated with and without each of the aprons present in both primary and scattered beams. The selected tube voltages were between 60 and 113 kVp with constant mAs, a fixed field size, and fixed source-to-object distance. ResultsNo significant difference in absorption ability of the two lead-free aprons compared with that of the lead apron was observed when the dose was measured in the primary beam. When measurements were performed in the scatter radiation field, the absorption ability of the OpaqFu apron was 1.3 times higher than that of NoLead apron and nearly equal to the absorption ability of the lead apron. An increase in the difference between the OpaqFu and NoLead aprons was observed for the tube energies higher than 100 kVp in favour of OpaqFu apron. ConclusionIt is safe to use the lead-free aprons that were tested in this study in a clinical environment for the tube energy range of 60 kVp–113 kVp.

Measurement of X-ray scattering during radiography of small animals

The radiation protection in the veterinary medicine is to be followed especially for persons occupationally exposed to ionizing radiation as well as for further persons who must help with the holding of an animal during radiography. Dose measurements were carried out in a veterinary clinic. Thereby, the doses were determined which occur at different points on the body of persons restraining the animal, with and without the protection of lead rubber apron. The result shows that a crouching position is counterproductive, because on the unprotected head including the eyes and thyroid gland up to the threefold dose compared to an upright position is reached. This instruction - besides to turn away the head or to close even the eyes - may require often that the radiograph must be repeated for a diagnostic image quality. Therewith, the conception of the radiation protection is in no way followed. The condition for an optimum protection against unnecessary radiation for the staff as well as necessary further persons is a suitable education by practically oriented teachers.

“Do lead rubber aprons pose an infection risk?”

This study was carried out in order to establish whether infection control measures were being undertaken sufficiently on lead rubber aprons within a diagnostic imaging department in the east of England. This study involved the swabbing of a sample of 15 lead rubber aprons used within different areas of the department. Swabs were taken from the area on the underside of the shoulders and from the front of the apron. Each apron was firstly swabbed to determine the current level of microorganism contamination (determination of baseline data) and then again after recommended cleaning with detergent and water (the production of a standard). Comparisons were then made between the number of microorganisms' present (colony forming units/cm 2) pre and post-cleaning at each location. Additionally, post-cleaning data was compared for each location. All aprons were found to be contaminated with microorganisms, those identified were Coagulase-negative staphylococci, Staphylococcus aureus, Bacillus, Diphtheroids and some fungal spores. No Methicillin resistant strains of Staphylococcus aureus (MRSA) were identified. Recommended cleaning with detergent and water was found to significantly reduce the amount of microorganisms present (the detergent used was Hospec general purpose neutral liquid detergent). Comparisons of the sample sites found that the front of the apron had lower levels of microorganism contamination post-cleaning than the site at the underside of the shoulders. The results suggest that the lead rubber aprons were not being cleaned sufficiently which has infection control implications for the department. In order for cross contamination to be kept to a minimum an effective infection control policy needs to be employed and this should be to carry out regular cleaning with detergent and water which has been shown can significantly reduce contamination.

腹部血管造影検査におけるX線防護衣の遮へい評価

Medical personnel involved in abdominal angiography are exposed not only to direct radiation but also scattered radiation from inspection tables, patients, image intensifiers, and the beam-limiting system (collimator), among others. Japanese standard JISZ4831 prescribes protective coats of at least 0.25 mm lead equivalent, which is the uniform thickness of lead equivalent. The most commonly used protective coats are 0.25 mm Pb, 0.35 mm Pb, or 0.5 mm Pb in thickness. The weight of a typical protective coat is about 3 kg. While some coats weigh up to 6 kg, wearing such heavy coats becomes physically burdensome as inspection time increases. The trade-off between physical burden and protection was considered by analyzing the X-ray intensity distribution and attenuation rate of scattered radiation in each position assumed by the medical staff. In the case of inspections performed at an x-ray tube voltage of 80 kV, it may be possible to reduce the weight of the lead rubber apron by about 33%. Namely, the lead thickness can be reduced uniformly by 0.20 mm Pb at 70 cm and 0.05 mm Pb at 100 cm, when the shielding capability of a 0.25 mm thick Pb layer is accepted as the standard at 40 cm above the gonad position. The same range of permeated X-ray dose for the gonad position may be reduced as well. In the case of 110 kV, when the lead thicknesses are 0.30 mm Pb at 40 cm and 70 cm, and 0.10 mm Pb at 100 cm, it is possible to reduce the weight of the lead rubber apron by about 28%.

Letter: Personnel monitoring in diagnostic radiology.

Some observations made by one of us (K. J. P.) of the doses received by four radiologists during investigations such as arteriography, angiography and neuroradiography indicated that the average ratio of the dose recorded on a monitoring film worn on the collar to that on a film worn on the trunk under a lead rubber apron was approximately 10:1.

Correspondence

Radiologists have always been conscious that their legs are vulnerable to radiation and that the protection afforded by a normal lead rubber apron attached to the screening stand is inadequate. The reason for this is that there is no screening of scattered radiation from the patient. If a dental film is worn in the turn-up of the trousers, it is not long before an appreciable dose can be recorded.

Radiation dosage to medical personnel.

A survey was made to evaluate exposure to those physicians and dentists employing radiation. Many medical personnel other than radiologists employ radiation such as the general practitioner, surgeon, urologist, and the dentist. It is emphasised that among the various specialty groups varied factors of kilovoltage, current filter, technique, etc., will result in completely different values of exposure both to the patient and worker. In the National Bureau of Standards Handbook X-ray Protection, recommendations as to total filter in the diagnostic x-ray beam are made. The 2.5 mm of aluminum recommended in medical- diagnostic units greatly reduces the exposure to patients and personnel. The use of lead-rubber aprons during fluoroscopy is also recommended. This paper presents figures on protection afforded by such aprons. Other specialists can reduce their exposure considerdbly by keeping their hands out of the primary beam. Dentists sometimes hold film in place. By avoiding this procedure and by utilizing a total of 1.5 mm of aluminum in the beam, they can reduce exposure to themselves and to the patient. Exposure values are presented for different techniques employed by specialists., A summary of film badge data is presented. (auth)

Hydraulic device for remote control of injection during carotid angiography.

We have long been concerned with the problem of exposure to irradiation in the performance of cerebral angiography. The lead rubber drapes suggested for protection have proved cumbersome in our experience. The amount of radiation scatter encountered with careful centering and the use of small cones still is hazardous. Automatic injection devices are limited by the handicaps incurred by losing the desired feel of the injection and the expense and complexity of such apparatus. Up to the present time we have used a combination of careful coning, lead rubber aprons on the operator, and a hasty retreat from the site of the procedure immediately after injecting the contrast medium. This has been fairly successful because the chance of disengaging the Cournand needle is lessened by attaching the syringe to the needle with a 12-in. length of flexible sterile plastic tubing (Venotubes, Abbott Laboratories). It occurred to us that a hydraulic

A homemade inexpensive manual rapid cassette changer for angiocardiography and cerebral angiography.

The purpose of this article is to describe a manual rapid cassette changer which anyone can make inexpensively (at a cost of less than $60.00) and to mention two advantages which it offers over previous devices. Briefly, the cassette changer consists of a “cookie sheet” to hold the cassettes as they are pushed manually through an elongated wooden channel which has lead covers on either side of the part of the body to be exposed. Wooden spacer blocks hold the cassettes in place in the “cookie sheet”: a long narrow spacer at the top of the cassettes when they are placed in the tray with their longest dimension crosswise of the x-ray table (lengthwise of the channel), and a short block the width of the tray when their longest measurement is parallel to the table (crosswise of the channel). A Lysholm grid is placed between the lead covers to complete the upper surface of the channel. Figure 1 shows the parts of the cassette changer with the technician holding the control rod in his right hand and the exposure switch in his left. Figure 2 shows the patient in place for a cerebral angiogram, with the needle in the internal carotid artery and the operator protected by the lower half of an old lead-rubber apron draped around the tube. Specifications The inside measurements of the wooden frame are 60 ½ × 13 ⅝ × ⅝ inches. The bottom of the channel is made of plywood and is nailed or screwed solidly to the sides. The inside surfaces of the sides are grooved near the top to accommodate the plywood and lead covers, each of which measure 24 × 14⅜ inches. One plywood and lead cover is fixed at one end of the channel, while the other has stops in its grooves so that it may slide 1 ½ inches from the near end of the channel. A ¼-inch hole (to accommodate a ¼-inch metal thumb key resembling a violin peg) is drilled through the end of one side of the channel at the proper place to bridge the groove for the movable lead cover so as to hold it 1 ½ inches from the grooved end. One-inch squares are cut from ⅜-inch plywood and nailed to the sides of the channel at points where they will guide the Lysholm grid and hold it in position over the opening in the middle of the channel. Four 4-inch wood clamps (C-clamps) suffice to hold the channel to the x-ray table. The cassette tray, resembling a “cookie sheet,” is made of galvanized tin. Its inside measurements are 39½ × 13¼ inches, with ½-inch sides. A 1-inch square flattened metal cabinet handle is soldered to one end of this tray, fitting into the key-seat near the end of the solid metal control rod. The key-seat is a round hole through the control rod with a slightly smaller slot, opening the hole to one side of the rod so that the metal cabinet handle will be barely admitted when the rod is in a vertical position and will not slip out of the key-seat when the rod is in a horizontal position, as shown in Figures 1 and 2.

RADIATION protection during diagnostic studies.

HomeRadiologyVol. 57, No. 6 PreviousNext EditorialRadiation Protection During Diagnostic StudiesPublished Online:Dec 1 1951https://doi.org/10.1148/57.6.886MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractWith the present widespread use of radiologic methods of diagnosis by both trained and untrained personnel, the problem of protection from direct and stray radiation has assumed increasing importance. In the case of the operator, the danger may lie in exposure to stray radiation over a long period of time or in injudicious exposure to direct radiation as a result of inadequate shielding or disregard of safety factors. The patient may be unwittingly over-irradiated because of poor judgment on the part of the radiologist or may suffer from the cumulative effect of successive examinations when a full history of earlier exposure has been withheld.Fluoroscopy is probably attended by the greatest danger unless adequate precautions are taken. Braestrup showed by measurement studies that increasing the target-panel distance from 8 to 12 inches reduced the skin dose about 33 per cent with the same r per minute at the screen. Decreases in the dose to the skin were shown to be obtainable, also, by an increase in the added filtration, a reduction of 50 per cent being accomplished by an additional 0.5 to 1.0 Al without any loss in the diagnostic value of the image. Smaller fields not only cut down the area of exposure but also reduced back-scatter and, finally, with higher voltage the skin dose was less for the same illumination.It was also found by Braestrup that the fluoroscopist may be the recipient of appreciable amounts of stray radiation when using a fluoroscope of the horizontal or tilt type, because of the space left between the shielding cone and the table top to permit movement of the Bucky diaphragm. This scattering is of much greater intensity than scattered radiation from the patient. The danger can be mitigated, however, by adequate shielding of the open space, although protective gloves and apron or a lead-protected chair are still highly essential. After ascertaining the number of r per minute received by the patient's skin on any given installation, a self-limiting fluoroscopic timer will add an excellent safety factor.In routine radiography there is little reason for the operator to receive any appreciable dose of radiation if the control is properly located and shielded, and if he exercises the basic rules of safety. Certain radiographic procedures, however, may entail excessive exposure unless special precautions are observed. The examination of infants and small children falls within this category, since often the child must be held by an attendant. This should be someone not regularly exposed to radiation, or a protective lead-rubber apron and gloves should be worn. Under no circumstances should an x-ray technician or operator hold dental films in the patient's mouth while an exposure is being made, as this will inevitably lead to severe radiation damage. Roentgen studies of the mentally defective also present a special problem, as these patients must frequently be held in position.Article HistoryPublished in print: Dec 1951 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 57, No. 6 Metrics Altmetric Score PDF download

A Rapid Cassette Changer for Angiocardiography

The following is a description of a simple, efficient cassette changer for use principally in angiocardiography. It permits the making of serial films at a speed faster than one per second. Usually, the first seven films are taken in four and a half to five seconds, and the rate is then slowed down so that the next four to six are finished in about fifteen seconds, depending on the problem under investigation. The changer consists of three basic parts: a tunnel for 11 X 14-inch cassettes, a lever mechanism to release the exposed cassette and arrest the following unexposed one, and an “approach” board. The x-ray team requires a “pitcher,” whose function is to push the cassettes through the tunnel and use the foot exposure switch (the anode rotating throughout the procedure), and a “catcher,” who aids in removing the exposed cassettes. For the protection of these two radiologists and the films, lead-rubber aprons are worn and lead shields are in place on each side of the patient. Measurements of the scattered radiation, with the Lansford instrument, show that the radiologists are well protected for the usual number of exposures required. If however, three or four angiographic studies were done each day, the limit of tolerance, i.e., 0.1 r would be approached. At the unprotected head of the table, where an anesthetist may be working, the Lansford instrument measured 0.07 r during one entire angiographic procedure. With a reasonable volume of work, the surgeon and the anesthetist need no shields or protective aprons. However, in institutions doing much of this work (e.g., four or more cases per day) mechanically operated apparatus would be preferable. The illustrations show the general type and design of the equipment, and also examples of the films obtainable therewith. It may be noted that the original trial model is still in satisfactory use. Acknowledgments: To Charles E. Grayson, M.D., for his design of the lever system, to A. Wayne Hackney, physicist, for the measurements of scattered radiation, and to Agnes Cameron for the drawings here reproduced, the author makes grateful acknowledgment.