A questionnaire study of radiography educator opinions about patient lead shielding during digital projection radiography.

BACKGROUND: In projection radiography, lead rubber shielding has long been used to protect the gonads both within and outside the collimated field. However, the relative radio-sensitivity of the gonads is considered lower than previously, and doses from digital projection radiography are reported as being lower than in previous eras. These factors, along with technical difficulties encountered in placing lead shielding effectively, lead to varied opinions on the efficacy of such shielding in peer reviewed literature. This current study has investigated what is currently being taught as good practice concerning the use of lead shielding during projection radiography.

METHOD: An online questionnaire was distributed to a purposive sample of 44 radiography educators across 15 countries, with the aim of establishing radiography educators' opinions about patient lead shielding and its teaching.

RESULTS: From the 27 responding educators, 57% (n = 15) teach students to apply gonadal shielding across a range of radiographic examinations; only 22% (n = 6) do the same for the breast, despite respondents being aware that the breast has higher relative radio-sensitivity than the gonads. Radiation protection was the primary reason given for using shielding. Students are generally expected to apply patient lead shielding during assessments, although a small number of respondents report that students must justify whether or not to apply lead shielding. Educators generally held the opinion that no matter what they are taught, students are influenced by what they see radiographers do in clinical practice.

CONCLUSIONS: The current study has not found consensus in literature or in radiography educators' opinions concerning the use of patient lead shielding. Findings suggest that a large scale empirical study to establish a specific evidence base for the appropriate use of lead shielding across a range of projection radiography examinations would be useful.