June 2025
In this VETgirl online veterinary continuing education blog, Julia Bitan, RVT discusses radiation safety concerning the frequency and testing of our personal protective equipment (PPE). Radiation safety should be practiced daily and reviewed regularly to ensure all members of the veterinary care team, including patients, are minimizing exposure. Part of routine safety measures is wearing PPE, and this PPE requires quality control checks to preserve our safety!

When and How to Test Your Personal Protective Equipment

By Julia Bitan, RVT, Founder, Hands-Free X-Rays

X-Ray imaging is an essential diagnostic tool in veterinary medicine and a big part of our everyday work. However, exposure to ionizing radiation poses potential health risks to veterinary staff who restrain patients during exposure and stay close to the x-ray source during exposure. Although the amount of radiation used in diagnostic procedures is relatively low, cumulative exposure over time can be harmful. This is why the proper use of personal protective equipment (i.e., lead PPE), is not only important but it is also a regulatory requirement in many jurisdictions around the world. This blog will discuss the importance of this type of equipment, how it works, the types commonly used in small animal practice, common causes for damage, the necessity of proper storage and fit, and how to perform annual integrity testing.

Why Do We Wear Lead PPE?

We wear lead PPE to protect ourselves from scatter radiation during x-rays. Remember, lead PPE will not protect from the primary beam! When manually restraining a patient for x-rays, always keep the gloved hand outside the primary beam and always consider hands-free positioning techniques to increase your distance. Scatter radiation, or secondary radiation, that deflects from the animal or other surfaces, can still expose staff to harmful rays and the lead PPE acts as a barrier from this secondary radiation, significantly reducing scatter radiation exposure to critical areas such as the chest, reproductive organs, thyroid, and hands.

How Does Lead PPE Work?

Lead is a dense material that effectively absorbs ionizing radiation. The garments are typically made with lead or lead-equivalent materials such as bismuth or antimony and come in various thicknesses, commonly 0.25 to 0.5 mm lead equivalency. The choice of thickness depends on the expected level of exposure. The types of PPE typically used in small animal hospitals include:

  • Lead gowns: Cover the torso to shield internal organs.
  • Thyroid shields: Protect the sensitive thyroid gland.
  • Lead gloves: Shield hands during manual restraint of patients.
  • Lead glasses: Less common; used to protect the eyes from scatter.
  • Caps and aprons: Used in some specialized or large animal practices.

Properly fitted PPE. Image courtesy of Julia Bitan.

Common Causes of PPE Damage

Despite being designed for protection – lead PPE is vulnerable to damage from both physical trauma and improper handling. Common causes of damage include:

  • Animal bites or scratches: A distressed or struggling animal can puncture gowns or gloves.
  • Improper storage: Folding or crumpling PPE can cause the lead core to crack or thin.
  • Rough handling: Dropping or dragging PPE items can damage the interior lining.
  • Wear over time: Like all protective gear, PPE degrades over time with regular use.

At the top of the x-rays the stitching holes are clearly visible. At the bottom, a black area can be seen indicating damage. Image courtesy of Julia Bitan.

Proper Fit and Storage Are Essential

A poorly fitted gown or shield may leave parts of the body exposed to scatter radiation. For example, if a thyroid shield gapes at the neck or a gown is too short or loose, vulnerable body parts may not be adequately protected. Therefore:

  • Choose PPE that fits snugly but comfortably.
  • Store gowns on dedicated hangers or lay them flat.
  • Avoid folding or placing heavy objects on top of PPE.
  • Clearly label each piece with the date of purchase to track its age and condition.

Proper storage is essential to ensure longevity and prevent damage like cracks or creases that can compromise its ability to block radiation. Image courtesy of Julia Bitan.

Life Expectancy and Record Keeping

Most manufacturers estimate a life expectancy of ~5 years for lead PPE under normal usage, but this can vary based on frequency of use and care. Equipment should be tagged with:

  • Purchase Date
  • Assigned ID Number (for testing purposes)

Keeping a detailed logbook or digital inventory of all PPE helps ensure timely inspections and replacements.

An example of a log sheet for PPE annual integrity testing. Image courtesy of Julia Bitan.

Annual Integrity Testing: Why and How

Integrity testing verifies that the PPE garment is still capable of providing the intended protection. Damaged PPE can contain cracks, holes, or thin areas that allow radiation to pass through. The ALARA principle (As Low As Reasonably Achievable) mandates that all reasonable steps be taken to minimize exposure, and annual PPE testing is part of this.

We will focus on three critical items commonly used in small animal practices: lead gown, thyroid shield, and gloves.

Testing Protocol

Before you begin:

  • Assign a unique ID number on each item (e.g., Gown A, Gown B, etc.)
  • Prepare a testing record sheet (paper or digital).
  • Use a standard exposure setting, such as what would be used for a kitten paw, with the collimator fully open.

Gown testing:

  1. Lay the gown flat on the x-ray table.
  2. Conduct a visual and tactile exam, checking for thinning or cracks.
  3. Radiograph each section using the established technique.
  4. Use edge stitching holes as landmarks and reference points.
  5. Look for dark areas on the radiograph that suggest compromised shielding.
  6. Record findings and ensure ID is clearly marked on the gown tag.

Open the collimator fully as shown and include the edges to visualize the stitching holes. Leave the room for exposure. Image courtesy of Julia Bitan.

Thyroid shield testing:

  1. Lay the shield flat and inspect it thoroughly.
  2. Radiograph the entire shield.
  3. Reference dark spots to stitching holes to determine if damage is present.
  4. Log results and verify that ID is attached to the shield.

Glove testing:

  1. Inspect gloves inside and out by feel and sight.
  2. Due to their double-layer design, standard x-rays may not reveal internal defects.
  3. If damage is suspected, use a dental radiograph sensor and x-ray machine to assess specific areas.
  4. Mark the results and ID on each glove.

After the Test: What Do the Results Mean?

  • No dark areas: PPE is intact and safe for continued use.
  • Small dark spots (<5mm): May be acceptable depending on location (consult your radiation safety officer).
  • Large or multiple defects: Replace the item immediately.

All test results should be logged and retained for future reference and compliance audits.

Creating a Culture of Safety

Annual PPE testing is more than a regulatory checkbox—it fosters a safety-first culture.

Encourage staff to:

  • Report damage immediately.
  • Participate in radiation safety training.
  • Use hands-free restraint techniques whenever possible.
  • Maintain distance from the beam source whenever practical.

Conclusion

Lead PPE is a frontline defense against scatter radiation in veterinary practices. Understanding how to properly use, store, and test this equipment ensures its longevity and effectiveness. Following routine inspection and integrity testing protocols protects not only the individual staff member but also reinforces the overall safety culture within the clinic. By committing to these standards and leading by example, veterinary professionals safeguard both their own health and that of their teams.

Remember: Radiation safety is everyone’s responsibility.

Please note that the opinions in this blog are expressed by the author, and not directly endorsed by VETgirl.

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