Occupational Health Hazards of wearing lead aprons
Radiation protective garments or lead aprons are considered essential for protecting healthcare workers from frequent radiation exposure during procedures which require x-ray equipment. However, it is well known that wearing lead aprons may result in chronic musculoskeletal pain, which may become disabling.
In the field of interventional cardiology, more complex and longer procedures, such as PCI of chronic total occlusions and structural heart procedures, have become more common.
The requirement of bending over and looking up at a monitor while wearing a weighted garment across the shoulders "results in awkward and unnatural stress points on the cervical and lumbar spine," which promote musculoskeletal injuries over time.
In a case-controlled multisite study by the Mayo Clinic published in the Journal of the American College of Cardiology
(1), 55% of the respondents reported musculoskeletal pain. There have been successfully designed and expensive systems which relieve the weight problem for the physician doing the procedures
(2) but there are other healthcare workers involved in these procedures who seem to suffer more musculoskeletal pain than the physician.
62% of technicians and 60% of the nurses versus 44% of the attending physicians in the Mayo Clinic study reported musculoskeletal pain (1).
This occurred despite the technicians and nurses being younger and having worked for fewer years.
Since the technicians and nursing staff do not typically rotate out of the interventional laboratory, they are exposed to more constant physical stress from wearing lead aprons.
One thing is certain, studies have shown that chronic musculoskeletal pain increases with higher case volumes and more years in practice for physicians (3,4).
The Mayo Clinic study also concluded the following:
“musculoskeletal pain is more common in healthcare workers who participate in fluoroscopically guided interventional procedures and is highest in non-physician allied staff. Female sex, increasing time per week participating in procedures requiring radiation, and increasing use of the lead apron are associated with a higher prevalence of musculoskeletal pain” (1).
JACC, Vol 65, Issue 8,3 March 2015, pp 820-826
Journal of Vascular and Interventional Radiology, Vol 20, Issue 2, February 2009, pp s53
Catheter Cardiovasc Interv, 63 (2004), pp. 407-411.
The American Journal of Cardiology, Vol 79, Issue 1, 1 January 1997, pp 68-70.