Burns Kevin M, Shoag Jamie M, Kahlon Sukhraj S, Parsons Patrick J, Bijur Polly E, Taragin Benjamin H, Markowitz Morri
Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
Department of Pediatrics, New York University Langone Medical Center, New York, New York.
J Am Coll Radiol. 2017 May;14(5):641-647. doi: 10.1016/j.jacr.2016.10.024. Epub 2017 Jan 9.
To determine whether lead-containing shields have lead dust on the external surface.
Institutional review board approval was obtained for this descriptive study of a convenience sample of 172 shields. Each shield was tested for external lead dust via a qualitative rapid on-site test and a laboratory-based quantitative dust wipe analysis, flame atomic absorption spectrometry (FAAS). The χ test was used to test the association with age, type of shield, lead sheet thickness, storage method, and visual and radiographic appearance.
Sixty-three percent (95% confidence interval [CI]: 56%-70%) of the shields had detectable surface lead by FAAS and 50% (95% CI: 43%-57%) by the qualitative method. Lead dust by FAAS ranged from undetectable to 998 μg/ft. The quantitative detection of lead was significantly associated with the following: (1) visual appearance of the shield (1 = best, 3 = worst): 88% of shields that scored 3 had detectable dust lead; (2) type of shield: a greater proportion of the pediatric patient, full-body, and thyroid shields were positive than vests and skirts; (3) use of a hanger for storage: 27% of shields on a hanger were positive versus 67% not on hangers. Radiographic determination of shield intactness, thickness of interior lead sheets, and age of shield were unrelated to presence of surface dust lead.
Sixty-three percent of shields had detectable surface lead that was associated with visual appearance, type of shield, and storage method. Lead-containing shields are a newly identified, potentially widespread source of lead exposure in the health industry.
确定含铅防护屏的外表面是否有铅尘。
本描述性研究对172个防护屏的便利样本进行了研究,并获得了机构审查委员会的批准。通过定性快速现场测试和基于实验室的定量灰尘擦拭分析(火焰原子吸收光谱法,FAAS)对每个防护屏的外部铅尘进行检测。采用χ检验来测试与防护屏的年龄、类型、铅板厚度、储存方法以及外观和射线照相外观之间的关联。
通过FAAS检测,63%(95%置信区间[CI]:56%-70%)的防护屏表面有可检测到的铅,通过定性方法检测的比例为50%(95%CI:43%-57%)。FAAS检测到的铅尘含量范围从不可检测到998μg/英尺。铅的定量检测与以下因素显著相关:(1)防护屏的外观(1=最佳,3=最差):评分为3的防护屏中88%有可检测到的铅尘;(2)防护屏类型:儿科患者用、全身用和甲状腺防护屏的阳性比例高于背心和裙子;(3)使用吊架储存:吊架上的防护屏有27%呈阳性,未使用吊架的为67%。防护屏完整性的射线照相测定、内部铅板厚度和防护屏使用年限与表面铅尘的存在无关。
63%的防护屏表面有可检测到的铅,这与外观、防护屏类型和储存方法有关。含铅防护屏是医疗行业新发现的、可能广泛存在的铅暴露源。