609 - Efficacy of D-Lead Wipes, Hydrogen Peroxide, and Soap in Reducing Surface Lead Contamination on Radiation Protection Apparel: A Zone-Randomized Study

Purpose: Lead radiation protection apparel (RPA) is routinely used in interventional radiology to reduce occupational radiation exposure. Prior studies have demonstrated persistent surface lead contamination, a heavy metal hazard with no known safe exposure threshold. This study evaluates the effectiveness of three cleaning modalities (D-Lead wipe [ESCA Tech, Inc], 3% hydrogen peroxide, soap with gauze) in reducing surface lead on RPAs using a randomized zone-based approach, addressing an occupational health risk in interventional radiology.

Materials and Methods:

We conducted a zone-randomized cleaning study of 35 lead aprons in a tertiary-care angiography suite between August and September 2025. Three high-touch zones per apron, the right upper chest (A), left upper chest (B), mid-abdomen (C), were sampled in 8 × 8 cm squares. Zones were randomized 1:1:1 to one of three cleaning interventions: D-Lead wipe (1 wipe), 3% hydrogen peroxide (1 pump), or soap with gauze (soaked and dried). Surface lead was assessed using an EPA-recognized rapid qualitative test before and after intervention. Zones testing negative at baseline were excluded from analysis. A no-intervention control confirmed assay stability over repeated testing. The primary outcome was a clearance in detectable lead residue post-cleaning.

Results:

105 randomized zones from 35 lead aprons were tested. Pre-intervention, 68.6% of zones (72/105) tested positive for lead residue. After a single cleaning, 24 of 72 pre-intervention positive zones were cleared (33.3%; 95% CI, 23.5%–44.8%; exact binomial, p < 0.0001). Post-intervention clearance rates were: D-Lead wipe 45.8% (11/24; 95% CI, 27.9%–64.9%), hydrogen peroxide 30.4% (7/23; 95% CI, 15.7%–50.8%), soap and gauze 24.0% (6/25; 95% CI, 11.5%–43.4%). Zone-specific clearance was highest for the left upper chest (B) at 71.4% (10/14; 95% CI, 45.4%–88.3%), followed by the right upper chest (A) at 25.9% (7/27; 95% CI, 14.0%–43.6%) and mid-abdomen (C) at 22.6% (7/31; 95% CI, 11.4%–39.8%). Zone B showed higher clearance compared to Zone A and C combined (71.4% vs 24.1%; OR 7.86; Fisher’s exact, p = 0.001). The overall difference between cleaning methods was not significant (Wald χ² = 3.7; df = 2; p = 0.16).

Conclusion: A single cleaning pass significantly reduces detectable surface lead on RPAs (p < 0.0001), with D-Lead wipes showing numerically higher clearance than hydrogen peroxide and soap (p = 0.16). Lead residue persisted in approximately two-thirds of zones after cleaning. Continued refinement of cleaning protocols is needed to enhance staff safety in high-radiation environments.