Summary of Current Radiation PPE is Failing to Shield Female Healthcare Workers:
Standard personal protective equipment (PPE) used by healthcare workers fails to adequately protect breast tissue from ionizing radiation, which could increase the risk of breast cancer in female healthcare workers, according to an article in The BMJ. The breast’s upper outer quadrant and axilla areas are most commonly exposed, so capped sleeves and axillary wings provide additional protection. Observational evidence reveals higher breast cancer incidence rates among female orthopedic surgeons than women in other specialties. The authors call employers to invest in “protective equipment that enhances the safety of all their staff.”
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Adequate Protection for Breast Tissue Cannot be Guaranteed by Standard Personal Protective Equipment; Employers Should Invest in Protective Gear that Ensures the Safety of All Employees.
Breast tissue is susceptible to radiation, a well-established human carcinogen. Doctors are urging employers to invest in improved ionizing radiation protection for women in healthcare who are regularly exposed to radiation through X-rays and other imaging procedures. Frequent exposure during image-guided procedures could increase the likelihood of female healthcare workers developing breast cancer.
In an article recently published in The BMJ, doctors argue that personal protective equipment (PPE), such as lead gowns used to shield the body from harmful radiation during procedures, provide inadequate protection to breast tissue. The area close to the armpit (the upper outer quadrant and axilla – the most common site of breast cancer) is exposed. Employers should invest in protective gear that ensures the safety of all employees, including additional protection such as capped sleeves and axillary wings to better shield vulnerable breast areas.
The Importance of Protective Gear
Occupational radiation exposure has not been identified as a risk factor for male breast cancer. However, regulations require the radiation dose delivered to all workers to be As Low As Reasonably Achievable (ALARA). According to the authors, the most effective way to achieve this is by reducing the exposure duration, increasing the distance from the source, and shielding all workers with adequate PPE.
The authors say adequate breast covering PPE could reduce radiation exposure and potentially help prevent breast cancer in female healthcare workers. They cite evidence suggesting an increase in breast cancer risk among female US orthopedic surgeons, as well as a small Finnish study showing breast cancer at 1.7 times the expected rate in radiologists, surgeons, and cardiologists compared with female physicians not working with radiation.
Improved Protection Equals Reduced Risk
In a study using artificial female torsos to measure radiation exposure, researchers found inadequate upper outer quadrant protection and no statistically significant reduction in dose when standard PPE was compared with a torso without PPE. Pilkington et al. point to additional protection, such as capped sleeves and axillary wings, which can be worn under standard gowns to protect the upper outer quadrant of the breast. The European Society for Vascular Surgery 2023 Clinical Practice Guidelines on Radiation Safety have already recommended female operators adopt this extra protection.
The authors state that providing appropriate protection is a legal requirement of employers, who have a duty of care to all workers exposed to radiation. The female breast appears to be particularly vulnerable, so employers must invest in protective equipment that enhances the safety of all their staff.
In conclusion, standard personal protective equipment fails to adequately protect breast tissue from ionizing radiation exposure. Employers are urged to invest in protective gear that ensures the safety of all employees, including additional protection such as capped sleeves and axillary wings to better shield vulnerable breast areas. RA’s minor investment can make a significant difference. Educating the risk of developing breast cancer can avoid absenteeism, disruptions in the workforce, and medical costs.
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