Radiation protection: Were we wrong all along?

‘Were we wrong all along?’ With this question, the expert summarised the overall uncertainty caused by the new recommendation. On the one hand, radiological technologists were now asking themselves whether decades of protecting their patients with lead aprons had been for naught. On the other hand, this same question also had to be addressed to the professional association that had supported this change. 

Weissensteiner said she understood that Austrian radiology technologists in particular - who enjoy one of the most comprehensive and high-quality training programmes in Europe - perceived the change as patronising. This was also clear from the feedback from her specialist colleagues: ‘Do we not have the expertise and professional training to choose the right radiation protection equipment for the patients entrusted to us depending on the situation?’, the expert quoted from one of the responses at the meeting.

Another aspect was the question of whether there was a risk of completely losing sight of radiation protection if lead protection for patients was abandoned entirely. This is where the expertise of radiology technologists is needed, emphasised Weissensteiner: ‘It's also about optimising dose reduction, these are the really effective measures, and this is where we can incorporate our expertise.’ The expert listed protocol optimisation, correct positioning of patients and reducing the scanning area as examples of this. If these requirements are met, additional protective gear is no longer necessary. She also stressed that the regulation is an appeal to take another close look at one's own equipment to see whether all dose optimisation parameters are actually set in the best possible way. 

However, not all radiology technologists appear to be completely convinced by the new regulation, as shown by a survey conducted by the professional association: Although the majority of respondents stated that they were in favour of the new recommendation, 28.3% admitted that they would still ask their colleagues for a lead apron to be on the safe side if they were being examined themselves.

Creating trust through empathy and expertise

The new regulation also has disadvantages for patients, the rtaustria President pointed out: ‘Patients have always felt protected by the lead apron - this is a very strong and well-learned cognitive element.’ Taking away this tangible protection could trigger fears that need to be taken seriously. ‘On the one hand, we have to create trust on an emotional level, and on the other hand, we have to provide information on a factual level. Weissensteiner emphasised that healthcare staff are needed in their role as trusted and competent advisers too: ‘It is up to us to explain to patients that digital advances and the expertise of radiology technologists mean that the use of lead aprons is no longer necessary.’

Successful appeal for uniform regulation

The new recommendation on ‘unleaded’ practice is based on international studies and developments - in particular the European consensus paper on patient shielding - and reflects advances in technology and training. However, inconsistent implementation is currently contributing to many patients feeling confused, the expert criticised. This referred to the lead apron requirement for dental X-rays, which was still legally required: ‘This is really confusing: the patient goes for a dental X-ray one day and is given an apron, but when they go for a knee X-ray the next day, they are not.’ This inconsistency must be ended by the legislator in the next amendment, Weissensteiner concluded. Meanwhile, this demand has been heard: since October 1st 2024, it is also no longer necessary to wear a lead apron for any dental X-ray examinations due to an amendment to the Medical Radiation Protection Ordinance.

26.02.2025

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• radiology (684)
• X-ray (287)