When to Wear a Lead Apron With a Thyroid Collar?

Pairing your lead apron with a thyroid collar is the most effective way to reduce radiation exposure if you’re performing interventional procedures. Radiography, C-arm fluoroscopy, CT scans, etc. all pose a risk to operator safety. The main source of occupational exposure is from scatter radiation exiting the patient.

Most radiologic professionals routinely wear a lead apron, but this doesn’t cover the neck area. They consistently neglect this critical region where the thyroid gland is located. As all radiation doses are cumulative, exposure throughout your career may cause the development of thyroid cancer. This hazard is completely avoidable.


Protection from Radiation Exposure

The use of ionizing radiation has enormous benefits when it’s correctly applied. However, wherever gamma and x-rays are employed for diagnostic or therapeutic procedures, proper controls must be implemented to prevent any deleterious consequences.

Long-term radiation studies have highlighted that there are clearly defined dose limits for parts of the body, beyond which damage will occur. These deterministic levels may not be reached after a single episode but after years of repeated exposure.

ALARA—“As Low As Reasonably Achievable” is the fundamental guiding principle in protection from radiation exposure. Every effort must be made to keep exposure to ionizing radiation as far below the dose limits as possible.

The three precautionary practices are:

  • Time: Ensure the length of exposure is the absolute minimum.
  • Distance: Keep as far from the radiation source as possible.
  • Shielding: Use protective barriers and personal protective equipment (PPE).

Suitable PPE is a prerequisite for any interventionist or radiologic professional who has to be next to a patient during exposure to ionizing radiation. Depending on the circumstances and medical procedure, recommended gear includes a lead apron and a thyroid shield, plus protective eyewear and lead gloves. Barrier Technologies® supplies an extensive range of all your necessary protective apparel.


When to Use a Lead Apron With a Thyroid Collar

Mandatory laws and regulations govern the use of lead aprons and thyroid collars, which vary from state to state. Although modern X-ray equipment and new technologies offer many benefits, prudence is always the best course of action for safety and reassurance.


When Do Medical Staff Need a Thyroid Collar?

In certain situations, in-room protective devices, structural shielding, and administrative controls can’t provide sufficient occupational radiation protection. These typically require staff to be present in the room, for example, image-guided interventional procedures, fluoroscopy, and mobile radiography.

Please view Barrier Technologies’ latest catalogs to select an x-ray apron and thyroid collar that suit your needs. In general, if a procedure requires you to be within 6 feet of an active beam, wear a lead apron. If you’re within 3 feet of the beam, add a thyroid collar. Let’s look at some specific instances and their guidelines:

1. Diagnostic Fluoroscopy, Including Mobile C-arm Systems:

Stanford University Environmental Health & Safety recommends a lead apron with a thyroid collar of a minimum of 0.25 mm, but preferably 0.5 mm lead equivalence, to reduce scatter radiation by 95%. Leaded eyewear is also indicated.

2. CT Scans:

Here too, the interventionist should do a lead apron with a thyroid shield, as well as protective eyewear.


When Do Patients Need a Thyroid Collar?

If a patient is undergoing any radiology procedure where the thyroid is in the line of, or very close to, the primary beam, then a thyroid collar should be provided. This can be paired with a lead apron if it doesn’t conceal the target area. Examples are:

  1. Dental Radiographic Examinations:

    Where possible, dress dental patients in a full lead apron and thyroid collar for intraoral imaging. This includes bitewing and full mouth examinations but excludes panoramic imaging.

  2. Cone-Beam Computed Tomography (CBCT):

    A lead apron paired with a thyroid collar offers close to a 93% reduction in the patient’s overall dose of scatter radiation.


Proper Ways to Use and Store Lead Aprons and Thyroid Collars

Practice these three behaviors until they become second nature!

  • Careful handling and storage — to preserve the integrity of the core material.
  • Attentive cleaning and disinfecting — to eliminate pathogenic microorganisms.
  • Regular inspections — to detect any damage timeously.


Guidelines for Wearing, Sharing, and Caring

#1: Ensure a Proper Fit

  • Your lead apron should hang squarely on your shoulders and extend 3–4” below your knees.
  • Your thyroid collar can be separated, sewn, or tethered to your apron.
  • Use Barrier Technologies’ award-winning X-ray Apron Sizer app. Download it from Google Play or the Apple App Store.


#2: Avoid Sharing Where Possible

  • It’s best to have your own PPE in a style and size that fits you.
  • If sharing, strict maintenance, inspection, and hygiene controls must be followed.


#3: Have Different Sets for Staff and Patients

  • This minimizes possible cross-contamination with harmful germs such as hospital-acquired infections (HAI).
  • Barrier Technologies offers disposable thyroid collars for temporary staff and patients.


#4: Clean Daily and Disinfect Between Wearers


#5: Store on a Proper Rack Without Folding or Creasing

  • Never fold or crumple your gear—you’ll crack the lead lining.
  • Hang on a sturdy hanger on a dedicated storage rack. We supply a range of specialized apron racks.


#6: Place Dosimeters Correctly

  • Follow the requirements instituted by your Radiation Safety Officer.
  • The general rules are:
    • On the side closest to the radiation source.
    • On the collar, close to the thyroid.
    • One outside and another inside your lead apron.


#7: Perform Regular Inspections

  • Perform regular visual and tactile inspections for cracks, creases, bulges, and thinning.
  • Perform periodic radiographic or fluoroscopic inspections for a detailed view.
  • Maintain a detailed inspection log. Try Barrier Track, our cloud-based tracker app!


Barrier Technologies: Meeting All Your Radiation Protection Needs!

Wearing a lead apron with a thyroid collar is essential attire for many radiologic procedures. Remember that these garments are shielding you from harm, so treat them with the utmost care and consideration.

Barrier Technologies constantly strives to anticipate and respond to the challenges experienced by the radiology community. We achieve our objectives with a two-pronged approach.

Firstly, we innovate and fabricate the most technologically advanced radiation protective apparel and accessories on the market. Secondly, we provide pertinent information to educate people about the hazardous effects of scatter radiation. Contact us today for expert advice or to place your order.