X ray protective aprons

X ray protective aprons

1. X-Ray Protective Aprons
Prof Amin E A Amin
Dean of the Higher Institute of Optics Technology
Prof of Medical Physics
Radiation Oncology Department
Faculty of Medicine
Ain Shams University

2. Introduction
A lead apron is a type of protective clothing that acts as a
radiation shield.

3. History
In I901, C.L. Leonard
advocated lead and
leather shielding suit.

4. History
•Antoine Henri Becquerel a French
scientist was a first person to introduce
lead apron and lead rubber gloves in
1906.
•Inhisleadapronheused100% lead.

5. History
•Henri Becquerel has use lead because it has a
high atomic number with highest atomic
density.
•So, it has a high attenuation coefficient.
•Thisapronwaseffectivebutwas heavy and
inconvenient to use for prolonged period of time.
(weight>5kg)

6. •In 1911, as X-ray became recognized as a
routine method of diagnosis, a British chemist
approached added lead powder to the rubber
mix.
•The result, was the production of an X-ray cloth
and the initial test X-ray is performed at Leeds
Hospital, stating that the experiment seemed
successful.
•From that time X-ray aprons, were began to be
manufactured.
History

7. Aprons Materials
❖The current aprons are made up of lead impregnated with
polyvinyl chloride(PVC), synthetic rubber,stabilizers.
❖These materials have been used for almost 100 years to provide
protection against radiation in hospitals.

8. Aprons Catagories
▪Apron generally comes in three thickness 0.25 ,0.35, 0.50 or1.00
mm
▪Shielding ability can be increase withincreaseinthicknessoflead.

9. Aprons Catagories
1)Standardlead
❖100% Lead
❖Weight 5 Kg or more
❖0.5 mm thickness and about 98% protection at 80KVp

10. Aprons Catagories
2) Leadcomposition(light weight)
❖Lead based composition (rubber, pvc)
❖Weight 25% less compared to standard lead apron (3-4 Kg)
❖0.5 mm thickness and about 99% protection at 100KVp

11. Aprons Catagories
3) LeadFree (zero lead)
❖Lead is not the only metal that protects us from X-ray beam.
❖Heavy metal like barium, aluminum, tin, antimony bismuth
(Bismuth Oxide Coated Fabrics) tungsten, titanium can also act
as protective barrier if used in correct composition.
❖Lead free aprons are made using the heavy metals except lead
impregnated in rubber, synthetics with its property made
equivalent to that of lead.
❖These aprons are 40% lighter than standard lead aprons.

12. Disadvantages of Lead
•Lead is not a desirable material for use in wearable radiation protection
due to its heavy weight, inflexibility, poor durability, ineffective for all
kind of radiation andtoxicity.

13. Disadvantages of Lead
•Every year more than 150,000 lead aprons are disposed of, adding in
excessofonemillionpoundoftoxic leadmetalwasteacrosstheglobe.
•Although there are safe ways to recycle lead garments, thelead-free
alternative is easier to recycle, without posing as a potential
environmentalpollutant.

14. ❖Weight of the apron will increase depending on the level and
areas of protectionrequired.
❖Standard lead apron are well-suited for shorter procedure.
❖The lead composite (light weight) apron are good for short
to medium lengthprocedure.
❖The lead free (ultra-light)apron are excellent for all length of
procedure especially longer procedure.
Which X-Ray Apron Material is Right
for Us

15. Protective Aprons Recommended For Use
Lead protective aprons must be provided for all staff carrying out
X-ray procedures where a fixed protective barrier is not made
available. The aprons:
➢must have minimum attenuation of 0.35 mm lead (Pb) for the front
section and not less than 0.25 mm of lead (Pb) for the remaining parts.
➢The most recommended is 0.5 mm lead equivalent.

16. Specifications of Protective Aprons
•Aprons and gloves must have radiation attenuation of no less
than 0.5 mm lead equivalence at 150 Kilovoltage Peak.

17. Use of Aprons
0.25 mm lead
60 kV; 100% 2 -3 %
100 kV; 100% 8 -15 %
Attenuation measured with lead aprons

18. Use of Aprons
0.50 mm lead
60 kV; 100% < 1 %
100 kV; 100% 3 -7 %
Attenuation measured with lead aprons

19. X-Ray Attenuation of Lead Aprons
Equiv. Thickness
(mm Lead) Weight50 kVp75 kVp100 kVp
0.25 mm 3-10 lbs.97 66 51
0.50 mm 6-15 lbs.99.9 88 75
1.00 mm 12-25 lbs.99.9 99 94

20. Recommended Thickness
▪The Medical Guidance notes (2002) issued by the Institute of
Physics and Engineering in Medicine (IPEM) regarding
protective clothing states “Body aprons should be available
with a protective equivalent of not less than 0.25 mm lead for
X-rays up to 100 kV and not less than 0.35 mm lead for X-rays
over 100 kV”

21. Specifications of Lead Aprons
•Full aprons should cover the front of the body from the throat to
within 10 cm of the knees as well as the sides of the body.

22. should be designed to cover at least:
•the front part of the body from the throat down to and including
the knees, the entire breast bone and shoulder
•the sides of the body from not more than 10 cm below the
armpit to at least half way down the thigh; and
•the back from the shoulder blades down to and including the
knees.
Lead Aprons Recommended For Use

23. Specifications of Lead Aprons
•All staff working in fluoroscopy or cineangiography must wear
a lead apron.
•If the operator’s eyes or thyroid are likely to receive dose from
radiation, it is advisable to wear additional protection for these
organs.

24. Two Piece Aprons
•Toavoidbackpaintwopieceaprons
arerecommended.
•Theseapronsconsistofseparate
skirtorkiltportionsandvest
portions.
•Theyaretypicallymadeinthewrap-
aroundstyletoprovideX-ray
protectiontothefrontandback.

25. Testing of lead aprons
Testing is performed using fluoroscopy on a floating top table.
While this will not measure lead equivalence, it will quickly
show faults, holes and apron deterioration.

26. Check of Lead Aprons
•Inspection and testing of protective clothing must be performed
as described by manufacturer.
•Lead aprons should be checked fluoroscopically at least on an
annual basis for their shielding integrity.

27. Lead Apron Integrity Check
•Objective:
–To assure that lead aprons, gloves, gonadal shields and thyroid collars
provide an ideal level of protection.

28. Lead Apron Integrity Check
•Performance Measurement:
–No breaks in lead lining of protective garments.

29. Lead Apron Integrity Check
•Frequency:
–At least annually or manufacturers recommendations.

30. Lead Apron Integrity Check
•Equipment:
–Lead aprons, gloves, gonadal and thyroid shields. Fluoroscopic or
radiographic unit.

31. Lead Apron Integrity Check
•STEPS:
•Option 1: image intensified fluoroscopy unit
•1. Lay out the item on the table.
•2. Examine the entire item using the fluoroscope.
•3. Record results on the Annual Quality Control Checklist.

32. Lead Apron Integrity Check
•STEPS:
•Option 2: image intensified fluoroscopy unit is not available:
•1. Closely inspect each item for kinks and irregularities.
•2. Take a radiograph of suspect areas.
•3. Process the film and look for breaks in the lead lining.
•4. Record results on the Annual QC Checklist.

33. Lead Apron Integrity Check
•CORRECTIVE ACTION: Any item displaying breaks in the
lead lining should be replaced.

34. Testing of lead aprons
•If there is any doubt about an apron, it should be withdrawn
from use until further advice is obtained.
•If damage to an apron is seen or suspected, it should be reported
to the Chief Radiographer immediately. The date on which the
testing took place should be logged against the individual
identification number for that lead protective apron for future
reference.

35. Rejection of Lead Aprons
•Rejecting an apron depends on the
location, area size and number of
flaws.
•It is best to keep the number of flaws
to a minimum.

36. Rejection of Lead Aprons
Photograph showing a normal lead apron (A); lead aprons
showing cracks and tears (B-G)

37. Criteria For Rejection
•Based on the cost of replacing lead protective aprons and the
estimated radiation dose received from a defect, it is suggested
that lead aprons be replaced if a defect is greater than 15 mm
2
.
•If the defect is clearly not over a critical organ then continued
use of the lead apron may continue, provided the location of the
defect is clearly marked on the lead apron and size, location
and date that the defect was identified logged in the
accompanying documentation.

38. Criteria For Rejection
•Defects not in close proximity of critical organs, which are
along the seam, or in overlapped areas, or on the back of the
lead protective apron should be subject to a less conservative
rejection criterion. In these cases, it is suggested that lead
aprons be replaced if a defect is greater than 670 mm
2
.
•Thyroid shields with defects greater than 11 mm
2
should be
replaced.

39. Disposal Of Lead Aprons
•According to the Environmental Protection
Agency, (EPA), lead is a highly toxic metal
that can cause severe health effects if
ingested.
•Products containing lead cannot be disposed
of as municipal solid waste, and must be
disposed of as hazardous waste or recycled.
•According to the EPA, lead aprons be
exempt from hazardous waste regulations if
they are recycled.

40. Where Do You Wear A Personal Dosimeter?
•When you wear a lead apron, you can wear your Personal
dosimeter in one of the following three way;
1.Under the apron
2.Outside the apron
3.Wear two dosimeter; one out side the apron and the other under the
apron

41. Wearing Personal Dosimeter Under Lead
Apron
•If you wear your personal dosimeter under the apron you will be
able to measure the radiation penetrated the apron to your body.
•This way of using personal dosimeter is recommended if you
wear thyroid collar and lead google.
•To estimate the radiation dose delivered to the uncovered parts of
the body such as arms and legs you can multiply the measured
dose by (100/5) because a 0.5 mm lead equivalent apron absorbs
95% of radiation and only 5% penetrate to the body.
•In our Hospital we recommended to use this way of wearing
dosimeters.

42. Wearing Personal Dosimeter Outside Lead
Apron
•If you wear your personal dosimeter outside the apron will be
able to measure the radiation delivered to the uncovered parts
of the body.
•This way of using personal dosimeter is recommended if you
do not wear thyroid collar and lead google.
•To estimate the radiation dose delivered to the thebody under
the apron multiply the measured dose by (5/100) because a 0.5
mm lead equivalent apron absorbs 95% of radiation and only
5% penetrate to the body.

43. Wearing Two Personal Dosimeter
•Wearing two personal dosimeter will allow you to measure
radiation exposure to both covered and uncovered parts of the
body

44. Recommendation
•We recommend to wear personal
dosimeters under the apron and
to wear thyroid collar because all
sensitive organs will by covered.

45. Caring of Protective Aprons
Do Inspect & Check Apron
•Inspect and check apron for:
❖Defects
❖Cracks
❖Creases
❖Lumps
❖Perforations

46. Caring of Protective Aprons
Do Inspect & Check Apron
The radiation safety
officer (RSO) shall check
lead aprons
fluoroscopically at least
on an annual basis for
their shielding integrity.
Defective aprons shall be
removed from use.

47. Caring of Protective Aprons
Labeling Aprons
When purchasing new
lead aprons, the RSO
shall label each of
them with a serial
number.

48. Caring of Protective Aprons
Labeling Aprons
•Each apron should be given an
individual identification
number, which should not be
removed.

49. Caring of Protective Aprons
Don’t Lean Against Sharp Edges
•To prevent puncturing the lead lining:
❖Avoid storing pointed objects in the
pockets
❖Do not lean up against equipment
❖Do not lean on pointed objects or sharp
edges

50. Caring of Protective Aprons
Recording
The RSO shall
maintain a record
of all aprons by
serial number,
location, and date
of last check.

51. Caring of Protective Aprons
Training
The RSO shall
train the users on
proper use,
storage, cleaning
and transport of
the aprons.

52. Caring of Protective Aprons
Do Clean Apron Regularly
•Clean daily and deodorize by scrubbing
with a soft bristle brush. Never use
products containing bleach. Rinse
thoroughly with water to remove residue.
Hang to dry. Do not machine launder or
dry-clean.

53. Caring of Protective Aprons
Do Clean Apron Regularly
•To prevent damage to apron:
❖Only use a soft bristle brush &
mild detergent
❖Never use bleach
❖Never soak or submerge in water
❖Never autoclave, machine
launder or dryclean
❖Hang apron to air dry

54. Caring of Protective Aprons
Do Clean Apron Regularly
Expensive light protective apron sent to the cleaning
hospital service without the appropriate instructions

55. Caring of Protective Aprons
Do Clean Apron Regularly
Expensive light protective apron sent to the cleaning
hospital service without the appropriate instructions

56. Caring of Protective Aprons
Do Clean Apron Regularly
Expensive light protective apron sent to the cleaning
hospital service without the appropriate instructions
Before
After (a bad) cleaning …
1,000$ lost!!

57. Caring of Protective Aprons
Proper Storage
•The manufacturer’s recommendations
regarding the handling and storage of
protective clothing must be strictly observed.
•Lead aprons should be stored on hangers to
prevent cracks in the protective lead.
•Aprons should be hung up by the shoulder(s)
or on an approved apron hanger.
•Aprons should never be folded or creased. If
possible, do not lay or store aprons on a flat
surface.

58. Caring of Protective Aprons
Proper Storage
•Follow apron manufacturer’s
recommendations
❖Store aprons on hangers when not in-
use
❖Avoid storing aprons on a flat surface
❖Aprons should be hung by the shoulder
❖Never fold or crease aprons
❖Always store with fasteners secured

59. Caring of Protective Aprons
Proper Storage

60. Caring of Protective Aprons
Proper Storage
The users shall hang up the
aprons by the shoulder(s) or
on an approved apron
hanger. Aprons should never
be folded or creased.

61. Caring of Protective Aprons
Don’t Wear Apron While Sitting
•Cracks in the lead lining can develop
❖Avoid sitting while wearing apron
❖Do not sit on the apron
❖Unless aprons are designed for seated
procedures (e.g. Urology Apron)

62. Caring of Protective Aprons
Don’t Expose To Extreme Temps
•To prevent damage to the apron:
❖Avoid exposing apron to the extreme cold
❖Avoid exposing apron to the extreme heat
❖Avoid exposing apron to direct sunlight

63. Caring of Protective Aprons
Apronstransporting
To transport an apron between different
locations, don't fold over the apron. The apron
shall be properly rolled.

64. Caring of Protective Aprons
Don’t Store Aprons OverChairs
To prevent creases fromforming:
●Avoid laying aprons over chairbacks
●Avoid placing aprons onequipment
●Avoid exposing apron to directsunlight

65. Caring of Protective Aprons
Don’t FoldAprons
•Note: Lead aprons
should never be
folded.
•Cracks in the lead
lining can develop at
the fold, reducing the
useful life of the
apron.

66. Caring of Protective Aprons
Don’t FoldAprons
To prevent damage to the leadlining:
●Do not foldapron
●Do not wadapron
●Avoid creasing theapron

67. Caring of Protective Aprons
Ensure Reliable ApronPerformance
To ensure safe and reliable apronperformance:
●Inspect apron uponreceipt
●Follow apron inspection intervalguidelines
●Store aprons properly when not inuse
●Depending on wear and tear, most aprons should be
evaluated for replacement every18-24months

68. Caring of Protective Aprons
Do Properly Dispose of Apron
•Lead Aprons are not conventional garbage
❖If possible, recycle lead aprons
❖Contact a recycling company or local landfill
❖If recycling is not possible, lead aprons must
❖be disposed of as a hazardous waste
❖Contact a hazardous waste hauler