By Greg Sackett, M.S., CHP

The inspection of radiation protective aprons is a mysterious requirement without much guidance.  Many hospitals and clinics have heard something about inspecting aprons, but many have questions as to what they need to do.

The primary requirement for protective apron inspection is given by the Joint Commission.  Some States also require inspection of protective aprons but Missouri, Kansas and Iowa do not have any such requirements.  This means that technically only those institutions accredited by the Joint Commission are required to inspect their protective aprons annually.

The Joint Commission requirement may be satisfied by physical inspection OR fluoroscopic examination of protective aprons annually.  While fluoroscopic examination is believed to be more thorough, it may not be necessary for newer aprons and may deliver unnecessary exposure to the persons testing the aprons.  Fluoroscopic testing may be considered for aprons considered suspect following physical examination.  If fluoroscopic testing is performed, low technique factors and not automatic exposure control should be used to reduce operator exposure.

The keys to a successful apron inspection program are as follows:

1. Uniquely identify each item of protective equipment with a number and some method of determining when it was last inspected.  This may be done on the label/tag itself or with a database that tracks all of the items and when they were inspected.  If a database is used, results must be available for inspection by the Joint Commission.
2. Develop a procedure for inspecting the protective equipment, either physically or fluoroscopically (or both).
3. Develop criteria for determining when protective equipment is defective.  Such criteria may include:
   • Tears, perforations, or seam separation.
   • Holes larger than 15 mm² unless it is not positioned over a critical organ.
   • Velcro that is no longer functioning.
4. Aprons determined to be defective should be removed from service immediately and disposed of properly (as hazardous material/waste if they contain actual lead).

Establishment of a protective apron inspection program may not be required at your facility but should be considered in order to give assurance to staff that the protective equipment they have available is not defective.

References:

• “Inspection of lead aprons: Criteria for rejection,” Operational Radiation Safety Volume 80, May 2001
• “Implementation of an X-ray Radiation Protective Equipment – Inspection Program” published in Operational Radiation Safety Vol 82, Feb. 2002, pp 551-553