Reusable lead aprons have long been viewed as essential radiation protection for clinicians, but infection prevention experts say they may also represent an overlooked environmental hygiene challenge.

During a recent Infection Control Today and Diagnostic Imaging roundtable, experts from infection prevention, perioperative services, and radiology discussed why lead garments often escape the scrutiny applied to other reusable equipment despite being used every day in patient care environments. 

Moderator Tori Whitacre Martonicz, MA, opened the discussion by asking whether reusable lead aprons have simply been overlooked rather than proven to be low risk. That question shaped a conversation focused on contamination, inconsistent cleaning practices, and the need for clearer guidance.

Peter Graves, BSN, RN, CNOR, argued that lead garments should not be dismissed simply because they are covered by sterile gowns during procedures.

“We don’t go back and culture the lead ever,” Graves said. “When we think about radiation-attenuating devices, lead actually functions much like PPE.”

Several panelists pointed to the absence of standardized cleaning protocols as a significant barrier. Jill Holdsworth explained that organizations may document cleaning activities, but there is often little consistency in how those garments are actually disinfected.

Justin McKay said ATP testing has proven to be one of the most effective ways to demonstrate the problem. In one comparison, he found lead garments in an operating room to be far more contaminated than a gas pump handle.

“When infection prevention sees the data, they say, ‘We cannot ignore this,'” McKay said.

The discussion also addressed practical challenges, including uncertainty about which disinfectants are compatible with lead garments, conflicting manufacturer recommendations, and questions over whether individual clinicians or hospitals are responsible for maintaining embroidered personal garments.

Brenna Doran, PhD, MA, ACC, CIC, AL-CIP, suggested that hospitals would benefit from a practical implementation guide.

“I would love there to be a playbook that IPs can go to,” she said. “It’s so much easier to do something someone else has done successfully than to create the wheel on our own.”

The panel concluded that addressing lead garment hygiene will require multidisciplinary collaboration and standardized protocols. As hospitals continue to strengthen environmental hygiene programs, experts believe reusable lead aprons should no longer be an infection prevention blind spot.