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    Ensuring hand protection in nuclear medicine

    Still, the usage of radioactive isotopes in molecular biology, biochemistry, and cell culture techniques persists.

    As it does not seem to be ‘state of the art’ any longer, the issue of safeguarding life sciences lab employees in nuclear medicine seems to be paramount.

    However, scant literature or standards address this concern directly.

    What about EN 421:2010?

    Can we refer to the EN 421 in personal protection against radiation isotopes risks?

    The En 421:2010 standard (Protective gloves against ionizing radiation and radioactive contamination) pertains to gloves for protection against ionizing radiation or radioactive contamination (excluding X-rays). However, most single-use gloves lack the necessary lead or equivalent metal content to meet these standards, raising doubts about their adequacy in protecting against ionizing radiation.

    What gloves provide sufficient protection when handling radiation isotopes?

    What gloves provide sufficient protection for example, if I use 90-yttrium markers or other radioactive isotopes or similar in radioimmunotherapy substances?

    The Federal Office for Radiation Protection in Germany underscores hands, particularly fingertips, face the greatest risk of skin exposure to radiation. Obviously, the risk of exposure is especially very high when preparing antibodies. (Source: Empfehlungen zum Strahlenschutz bei der Radio Immuntherapie mit 90Y-Markierten Antikörpern – Bundesamt für Strahlenschutz (Stand: August 2013) https://www.bfs.de/SharedDocs/Downloads/BfS/DE/broschueren/ion/fachinfo/infoblatt-radioimmuntherapie.pdf )

    With recorded skin dosimetry during the labelling, values of up to 600 mSv were measured by repeatedly touching unshielded syringes and reaction vessels with the fingers. The recommended annual values were thus far exceeded since the recommended annual limit for skin exposition of occupationally exposed persons is 500 msV (Source: Verordnung über den Schutz vor Schäden durch ionisierende Strahlen (Strahlenschutzverordnung – StrlSchV). Bundesgesetzblatt, Teil I, Nr. 38 vom 20.07.2001). Also, despite the use of latex gloves, skin contamination was observed repeatedly. This is leading to the recognition of nitrile gloves as a superior alternative.

    Are nitrile gloves wearing recommended during radioactive isotopes handling?

    Several studies have been conducted and answer this concern.

    Research from Italy supports the efficacy of synthetic gloves over latex in protecting against radiopharmaceutical permeation against [99mTc]-pertechnetate [18F]-FDG (Source: Permeability of gloves used in nuclear medicin departments to [99mTc]-pertechnetate and [18F]-fluorodeoxyglucose: Radiation protection considerations - S.Ridone, R. Matheoud, S.Walzano, R. Di Martion, L. Vigna, M. Brambilla, 2013 https://www.sciencedirect.com/science/article/abs/pii/S1120179713000069).

    Findings from Brazil offer further insights. Comparative analysis, including permeation testing against [131I] iodine, revealed nitrile gloves as the most effective option. They showed no detectable contamination within the initial 10 minutes and significantly lower permeation rates after 15 minutes compared to latex and vinyl gloves (Source: Effectiveness of polymeric gloves in radioprotection against contamination in nuclear medicine - Silva, L.P., Slazar, J.B. Fischer, A.C.F.S, Oliveira, F.R. Stedile, F.C 2023 https://doi.org/10.15392/2319-0612.2023.2187).

    All known studies and literature emphasize the importance of adhering to radiation protection measures and occupational health and safety principles. These include substitution, technical solutions such as shielding, organizational measures like optimal workplace preparation and regular training, and the use of appropriate personal protective equipment, notably nitrile gloves in this context.

    It is worth noting that thicker gloves generally offer better protection. For further inquiries, please:

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