Evaluation of radiation integrity and transmission in lead-rubber layers: a comparative analysis of visual-palpatory, light source and radiographic inspection methods

Occupational use of ionising radiation in medical procedures requires stringent protective measures to reduce exposure risks for staff. This study examined the integrity and reliability of personal protective equipment (PPE) used in a hospital setting, focusing on methods for detecting damage and its impact on radiation transmission. A total of 64 lead-based protective coats (one and two pieces) were examined for damage using four inspection techniques: visual- palpatory examination, LED light source, computed tomography (CT), and fluoroscopy/conventional x-ray. In the second part of the study, the transmittance of the primary beam and scattered radiation through damaged and undamaged areas was measured. Damage was found in 25% of protective coats, with 15.6%-18.8% classified as unsuitable according to recommended rejection models. Inspection using fluoroscopy and conventional x-ray was the most accurate method for detecting damage, followed by CT. Visual-palpatory, and light source assessments were less reliable, detecting 73.6% and 47.4% of all defects, respectively. Transmission of the primary beam in damaged areas increased from 0.5% to 316.6% compared to undamaged areas. Defective areas led to increased radiation exposure, potentially resulting in higher occupational doses and health concerns. The study emphasises the need for routine PPE inspections and recommends incorporating comprehensive assessments, including radiographic evaluations, into annual quality assurance and quality control protocols, as these have been shown to be most effective, particularly assessments using conventional x-ray units and fluoroscopy. These measures can significantly reduce the risk of unnecessary radiation exposure. However, time efficiency, required resources, and potential risks should also be considered and further evaluated.