Webinar: Are Lead Aprons an Overlooked Source of Pathogen Transmission in Radiology?

Justin McKay, cofounder of RadCare Services, said years of servicing thousands of lead garments have reinforced the need for routine cleaning.

"The gross factor is real," noted McKay. "Some of our labor positions ... have a dry-heave counter on their whiteboard because of what they see and smell coming off of the garments."

He also challenged the assumption that newly purchased lead garments are clean.

"Garments aren't made in what you call a clean environment," explained McKay. "Ten people have touched it, and it shows up at your place ... because it's assumed to be clean."

McKay said adenosine triphosphate (ATP) testing frequently identifies contamination on both new and heavily used garments.

"When a garment...ATP tests at 20,000 RLUs (relative light units), and it comes back at zero after cleaning ... the light bulb kind of goes off," said McKay. "There's probably a better way we could be doing this."

Pertinent Principles for Cleaning, Storing and Inspection of Lead Garments

McKay pointed to recommendations from the Association of periOperative Registered Nurses for cleaning high-touch equipment and suggested that hospitals begin by implementing scheduled deep cleaning and routine wipe downs of lead garments.

Over the past decade, the conversation has evolved beyond simply cleaning lead garments, according to McKay.

"We've evolved into a true management partner," explained McKay. "We'll talk about storage racks, proper storage, scheduled deep cleaning, inspections between cleanings, and garment fit. People best support what they help to create, so present options and let teams build the process together."

(Editor’s note: For related content, see “How Radiology Facilities Can Help Reduc e Health-Care Associated Infections.”)

The panel agreed that improving lead garment hygiene begins with leadership engagement, standardized protocols, and practical implementation strategies that support both patient safety and environmental hygiene.

Peter Graves, BSN, RN, CNOR, an operating room leader, admitted that lead apron management is often overshadowed by countless competing priorities but believes it deserves a much higher profile.

"If it's not on your radar, it should be," maintained Graves. "We have to do better."

He encouraged perioperative leaders to treat lead garments like any other piece of protective equipment.

"Make sure your staff is cleaning. Make sure your staff is inspecting. Make sure your lead is hung up correctly," implored Graves. "Everything is supposed to be clean, and if it's not, we have to do better."

What Future Research May Reveal About Contaminated Lead Garments

Looking ahead, Brenna Doran, PhD, MA, ACC, CIC, AL-CIP, an infection preventionist, challenged the infection prevention community to generate stronger scientific evidence linking contaminated lead garments to healthcare-associated infections.

"I would really love somebody to do cultures and PCR and see if we can make an epidemiologic link between some of our [methicillin-resistant Staphylococcus aureus] or Staphylococcus aureus surgical site infections and lead aprons," posited Dr. Doran.

A Multidisciplinary Effort for Ensuring Reduced Contamination Risks with Lead Garments

The panelists agreed that any future guidance should be a multidisciplinary effort. Graves recommended involving radiology, interventional radiology, emergency departments, and other procedural areas to develop standardized protocols across the health system to help reduce contamination risks and strengthen patient safety.

(Editor’s note: This article/video was adapted from its original publication on Infection Control Today at the following link: https://www.infectioncontroltoday.com/view/-we-have-do-better-infection-prevention-experts-warn-lead-aprons-may-be-overlooked-source-pathogen-transmission .)