Evaluation of bacterial presence on lead X-ray aprons utilised in the operating room via IBIS and standard culture methods

Clinical Issues-April 2021

Scrubbed team members leaving the OR while x-rays are taken Key words: radiation source exposure, x-ray, distance and shielding, radiation protection devices, inverse square law. Cleaning radiation protection garments and devices Key words: radiation protection, cleaning reusable garments, eyewear, lead aprons, shielding devices. Implementing radiation precautions for pregnant health care workers Key words: scatter radiation, shielding, dosimeter, pregnant health care worker, protective garment. Protecting patients from radiation exposure Key words: scatter radiation, radiation protection devices, radiation shielding, radiation protection drapes, patient exposure. Wearing x-ray aprons that fit correctly Key words: body size, radiation protection garment sizing, x-ray, lead aprons, anthropomorphic phantom.

Microbial Contamination Risk and Disinfection of Radiation Protective Garments

ABSTRACT

Healthcare-associated infections are a major public health concern for both patients and medical personnel. This has taken on greater urgency during the current COVID-19 pandemic. Radiation Personal Protective Equipment (RPPE) may contribute to risks of microbial contamination. This possibility was tested in 61 personal or shared-use lead aprons and thyroid collars at Columbia Presbyterian Irving Medical Center. Fifty percent tested positive for either bacterial or fungal contamination, mostly around the neckline of lead vests and thyroid collars. Repeated testing of garments some weeks to months later confirmed continued presence of microbial contamination. The possibility that hospital-approved disinfection agents could degrade the radio-protective features of these garments was also examined. Samples of identical construction to garments in regular use were subjected to either daily or weekly wipes with hypochlorite or alcohol-based hospital-approved cleaning agents for 6 mo. A third group of samples was maintained in contact with the cleaning agents for 6 mo. All samples were fluoroscoped four times during the study. None demonstrated any degradation in radioprotection. All samples were photographed monthly. Physical degradation of the outer plastic covering by concentrated hypochlorite and limited mechanical damage around stitched seams of the samples cleaned daily with alcohol was noted. Based on the high prevalence of microbial contamination, regular cleaning and disinfection protocols should be implemented. Regular cleaning with medical-facility-approved cleaning and disinfecting agents is likely to be effective at reducing the microbial load and unlikely to result in significant reduction in radioprotective properties of these garments.