April 18, 2023

Study Explores Lead-Dust Contamination in Protection Apparel

April 18, 2023—In an occupational health safety study evaluating the presence of surface lead-dust contamination on radiation protection apparel (RPA), Manocchio et al found that 60.9% of RPA sampled were contaminated with surface lead dust, with a significantly higher prevalence of surface lead dust found on thyroid collars versus lead aprons. Results were published in Journal of Vascular and Interventional Radiology.

KEY FINDINGS

Approximately 60% of 69 RPA samples were contaminated with surface lead dust.
11.6% of RPA were found to be worn or in poor condition.
Significantly higher surface lead-dust contamination was found on thyroid collars as compared with lead aprons.

Investigators undertook a survey of surface lead-dust contamination on RPA located on wall-mounted racks outside the angiography suite and emergency department of a tertiary care university hospital, the largest academic center in Canada. RPA were tested on three separate occasions from June to December 2021.

A rapid qualitative test (Leadcheck, 3M) was performed on-site to evaluate the presence of surface lead-dust contamination. Swabs were taken of a 15- X 15-cm region in the middle of the right anterior surface of both lead aprons and thyroid collars.

A total of 69 RPA were tested for surface lead-dust contamination during the study period, including 11 full-length front lead aprons, 25 full-length frontal lead aprons with 25 thyroid collars, and eight thyroid collars alone, all from a single manufacturer. Per inspection by one study investigator, 11.6% of RPA were found to be in worn or poor condition, and one RPA failed the annual quality control check and was disposed of.

On-site qualitative testing found an overall prevalence of surface lead-dust contamination of 60.9% (95% CI, 49.1%-71.5%). There was a significantly higher prevalence of surface lead-dust contamination on thyroid collars as compared with lead aprons (78.8% [95% CI, 62.2%-89.3%] vs 44.4% [95% CI, 29.5%-60.4%]; P = .0035).

The high prevalence of surface lead-dust contamination found on RPA in this study is consistent with the results of previous studies, noted the investigators. Health risks of lead exposure from RPA should be further investigated.

ENDOVASCULAR TODAY ASKS…

Study investigators Kieran Murphy, MD, FRCPC, FSIR, Professor of Interventional Neuroradiology, with University of Toronto, University Health Network and Toronto Western Hospital, and Gaylene Pron, PhD, with Dalla Lana School of Public Health, University of Toronto, were asked about the motivations behind the study, factors that might affect lead-dust contamination, and their recommendations for quality control testing of RPA.

What first motivated you to look into lead-dust contamination as a possible concern?

Dr. Murphy: I have been concerned about occupational hazards to physicians and staff radiology departments for some years. I have developed an antioxidant formulation, DNA halo, that decreases DNA damage from X-ray exposure. I became aware of the issue of elevated lead levels in the hair of x-ray technologists who worked in the angio suites. This implies they ingested lead powder by direct contact. This is not found in the hair of technologists using ultrasound, and I wanted to learn how common it was to find free lead dust on the aprons worn at University Health Network.

Your findings included higher prevalence of contamination on thyroid collars than aprons; what factors might lead to this variance between locations?

Drs. Murphy and Pron: The thyroid collars are exposed to more forces, folding, sweat, and humidity and may break down quicker than the flatter surfaces of mid chest or torso plastic coverings on lead aprons.

What is currently known about how protective apparel is tested, including long-term durability?

Drs. Murphy and Pron: There are no checks on the barrier protectiveness of lead aprons once they are sold. The lead aprons usually are x-rayed annually for cracks in the lead, but the plastic covering is not checked.

Your paper concludes with a push for frequent monitoring of physical defects but also lead-dust contamination. How frequently should facilities test their protection apparel and by what means? How will your findings affect your practices?

Drs. Murphy and Pron: These checks should be performed at least once a year. In our review, we also found there did not appear to be any effective or validated system for cleaning these garments, and this area should be investigated further. In either case, contaminated aprons should be replaced. There is no safe lead level in the body. Lead is more toxic than asbestos.

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