Patients often expect to wear a heavy lead apron during an X-ray to shield their bodies from radiation. However, as technology has advanced, so has the approach to shielding — grounded in scientific research, patient safety, and improved diagnostic accuracy.
The radiation dose from diagnostic X-rays today is up to 25 times lower than it was more than 70 years ago. As a result, the risk to patients has also significantly decreased.
Health Canada has updated Safety Code 35 to align with recent advancements in radiation protection standards.
This practice is also supported by the Canadian Association of Radiologists, the Canadian Association of Medical Radiation Technologists, and medical organizations across the country and neighbouring countries. It has also been applied by hospitals across Canada.
Therefore, as of January 28, 2025, we will no longer require patients to wear lead shielding while undergoing any exam that uses X-rays.
Dr. Mitesh Mehta, our Chief of Diagnostic Imaging, shares that recent studies show shielding the gonads (reproductive organs) and fetus during X-rays offers little to no benefit in reducing radiation exposure. In many cases, shields can obscure vital information in the images, potentially leading to missed diagnoses or the need for additional imaging. This is particularly important when imaging organs in the region of interest.
“When a pregnant patient gets an X-ray on their chest and wears a shield, the radiation passes through the chest, where it gets deflected by the patient’s bones down towards the shield,” says Dr. Mehta. “The X-ray beams then bounce off the shield and could be redirected back into the patient’s body. This could result in a higher radiation dose than if no shield were used.”
Shielding can also compromise the diagnostic quality of X-rays, potentially hiding incidental findings like tumours or kidney stones. Dr. Mehta recalls a patient who wore a shield during an abdominal X-ray. The shield obscured a kidney stone located near the bladder, leading to a missed diagnosis. To further investigate where their pain was coming from, the patient later needed a CT, exposing them to additional radiation.
“Our staff will continue to inform patients and families about the science behind the changes, the benefits and risks, and ensure everyone feels, safe, supported, and valued.”
Dr. Mitesh Mehta, our Chief of Diagnostic Imaging
“We understand this new method will be an informational shift for some patients,” says Dr. Mehta. “While shielding is no longer routinely used, patients will not be denied a shield if they request one. Our staff will continue to inform patients and families about the science behind the changes, the benefits and risks, and ensure everyone feels, safe, supported, and valued.”
Staff will continue to wear shields as they are exposed to radiation countless times per day. Staff exposure mainly comes from scatter radiation, which occurs when X-rays bounce off the patient’s body and toward the staff member.
“While the amount of radiation in a single X-ray is minimal, cumulative radiation exposure over time can be a concern,” says Dr. Mehta. “For patients who may require several X-rays in one year, the radiation exposure remains low, compared to a medical radiation technologist who is completing multiple X-ray exams a day, year-round.”
We remain committed to delivering consistent, safe, high-quality care and an extraordinary patient experience, focused on improving both clinical and patient outcomes, aligning with best practices, and ensuring the patient voice is integrated into all our improvement efforts.
For more information and frequently asked questions related to shielding, visit Diagnostic Services.
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This article appeared in the March 2025 issue of The Link. To receive Oak Valley Health’s community newsletter, subscribe now.