Why Do Surgeons Wear Lead Vests?
Personal protective equipment (PPE) is commonly used during interventional surgery using equipment like C-arms and fluoroscopy. However, what’s the purpose of PPE, like lead vests, aprons, and thyroid shields?
Protective garments, such as lead vests, are necessary during procedures using equipment that emits harmful scatter radiation. Clinicians regularly exposed to occupational radiation can experience many adverse health effects if they don’t take the proper protective measures.
We’ll provide a comprehensive overview in the remainder of this article to explain why lead vests are an essential safety measure and how medical facilities can ensure their staff members remain safe during high-dose procedures.
Why Do Surgeons Wear Lead Vests During Surgery?
Lead vests, thyroid shields, glasses, and other PPE are a primary component of surgical safety when using equipment that emits scatter radiation during procedures.
For instance, C-arm-guided fluoroscopy is necessary for many interventional procedures to provide real-time imagery for precise decision-making. However, AORN states that the average C-arm emits 2 rem (20 mSv) of radiation per minute, and the FDA stresses that fluoroscopy emits relatively high radiation doses. Therefore, this requires proper protection for clinicians who are regularly exposed.
Additionally, OSHA’s standards mention that clinicians in medical settings be exposed to a maximum of 1.25 rem of radiation to the whole body each quarter. Using a C-arm for just one minute without shielding could exceed that.
Wearing the proper PPE will reduce radiation doses significantly. A study from the Journal of Clinical Orthopedic Trauma showed that 0.5 mm lead aprons or two-piece vest and skirt sets can attenuate up to 99% of scatter radiation. Therefore, they are a key component in radiation safety.
Why Do Surgeons Wear Cooling Vests?
Surgical environments can heat up quickly when multiple pieces of equipment are running, especially during procedures that require surgeons to bend, move, and perform precise operations. Furthermore, protective garments like lead vests and aprons are heavy, which can cause additional heat and discomfort for surgeons during prolonged procedures.
Wearing cooling vests can provide extra comfort in surgery. A study in 2023 showed that cooling vests worn during major orthopedic surgery lowered core and skin temperatures, decreased reported sweating and fatigue, and improved perceived thermal comfort for surgeons.
Cooling vests are usually compatible with other surgical garments, so they can fit safely under lead vests or aprons to receive the benefits of both.
Why Are Lead Aprons No Longer Recommended?
In February 2024, the American Dental Association (ADA) released an update to its guidelines stating that lead aprons, thyroid shields, and other PPE are no longer necessary during dental X-rays using modern equipment. Modern dental X-rays that are properly calibrated emit much lower radiation levels, so there’s minimal risk when capturing a quick image.
However, that statement doesn’t apply to medical operations. Equipment like C-arms and fluoroscopy in surgical procedures emits much higher doses of radiation that require wearing shielding for occupational safety. The International Atomic Energy Agency (IAEA) stresses that lead aprons are a fundamental radiation protection measure and should be worn by everyone in the fluoroscopy room (except for the patient).
The Development Of Lead-Free Aprons
Lead-free aprons are another piece of modern safety equipment that may impact how much clinicians use lead aprons to protect against radiation. Lead-free garments that use alternative materials like bismuth, tungsten, and antimony are lighter, helping reduce fatigue for clinicians who wear them for extended timeframes.
A study in the European Journal of Radiology found that lead-free aprons performed similarly to traditional lead aprons at lower intensities below 90 kVp. However, traditional lead demonstrated superior performance as radiation intensity exceeded 90 kVp, suggesting that lead aprons remain the preferred choice for many high-intensity surgical procedures.
It’s best to consult with your facility’s radiation safety officer to determine the right material and type of PPE to wear for each procedure.
Two-Piece Lead Vest And Skirt Sets Offer Another Alternative
When traditional lead is a better fit for procedures, lead vests offer another alternative to reduce fatigue. Typically, you’ll see lead vests as part of a two-piece vest and skirt set. The two-piece set distributes the weight between the shoulders and waist, rather than only hanging from the shoulders like a traditional lead apron.
A study from PLOS One found that wearing two-piece radiation protection reduced shoulder fatigue and weight pressure for medical staff members.
What Happens If You Don’t Wear A Lead Apron?
Many occupational health risks are associated with ongoing radiation exposure. The National Institutes of Health mentions several radiation risks for healthcare workers regularly exposed to it, including higher chances of tissue damage, cataract formation, and cancer. Wearing shielding minimizes those risks significantly.
Additionally, failure to adhere to OSHA’s standards for occupational radiation exposure could lead to legal consequences for medical facilities and organizational leaders, such as fines, lawsuits, or imprisonment. OSHA encourages workers to reach out if their employer isn’t following regulations.
How Our Services At RCS Can Help
Wearing PPE like lead vests and aprons during high-dose surgical procedures is an essential safety measure. However, protective garments can accumulate damage, dirt, germs, and contaminants with regular use, which pose other safety hazards or reduce their effectiveness.
For instance, a study from Dr. Jaber of Wayne State found that 84% of lead aprons assessed were contaminated with Staphylococcus aureus and Tinea species (ringworm), and 12% were contaminated with MRSA. Deep cleaning is necessary to remove those tough microorganisms and prevent them from getting out of control.
At Radiological Care Services (RCS), we can help busy medical facilities clean, inspect, and maintain protective garments. Our services include:
Deep cleaning and disinfection
Annual inspections using X-ray scanning
Garment repairs
Garment disposal
New garment purchases
Inventory management using our RADCOMPLY™ software
Our services follow recommendations from governing bodies like the CDC and AORN to ensure compliance and effectiveness.
Contact us today to learn more about how RCS can make a difference for you.