“Shed the Lead”: Eliminating Routine Gonadal Shielding of Patients at Duke Health

For decades, it has been routine practice for radiologists to place lead shields over the ovaries and testes of patients who are having clinical radiographic procedures. The justification of this practice was to prevent x-rays from causing harmful DNA mutations that might be inherited by future offspring. However, the underlying research in support of gonadal shielding was done by studying the effects of x-rays on fruit flies. Fifty years of study suggests that hereditable mutations do not occur in humans at the radiation levels used in diagnostic radiology. In fact, the practice may actually be harmful: the shields sometimes cover up anatomical structures of interest, cause pathology to be missed, or make repeat x-rays necessary. Because gonadal shielding fails to achieve its intended purpose, organizations including the American Association of Physicists in Medicine, the American College of Radiology, the American Society of Radiologic Technologists and the National Council on Radiation Protection and Measurements have endorsed the discontinuation of this outmoded practice.

The Radiation Safety Division of OESO is assisting Duke radiologists in this initiative by:

• Educating x-ray technologists and non-radiology practitioners about the radiation protection principals and risk evaluations behind “shedding the lead” through live presentations and videos.
• Educating the patient community and referring providers about Duke Health’s elimination routine gonadal shielding through development of MyChartTM messaging, printed material and point of contact material.