The anatomy of the female body requires special consideration when it comes to X-ray protection: protective clothing should not only be as comfortable as possible, but also fit the female figure. This is by no means about fashion, but about efficient radiation protection.
Recent US scientific studies have shown a 1.9-fold increase in overall cancer incidence and a 2.9 to 3.9-fold increase in breast cancer incidence. This alarming data relates to female orthopaedic surgeons [1-3].
Occupational radiation exposure has also been associated with an increased prevalence of breast cancer in women in other healthcare groups, including US female radiological technicians, Chinese female radiographers and Finnish female physicians [4,5,6].
Anna Uhlitz, Head of Product and Project Management MAVIG
“Breast tissue is particularly sensitive to radiation, which is why it should be protected at all costs. In ICRP Report 103 from 2007, the weighting factor for the breast was set to the highest value of 0.12 with the red bone marrow, the lungs, the stomach and the colon,” says Anna-Luisa Uhlitz, Head of Product and Project Management at MAVIG.
Anna-Luisa Uhlitz points out that unsuitable protective clothing does not offer sufficient protection in either direction: “Protective clothing that is too small does not cover the body sufficiently. Protective clothing that is too large is unnecessarily heavy and has neck and arm openings that are too large, which also leads to insufficient coverage. Incidentally, this applies to all medical personnel who are exposed, not just women. It is important that the appropriate sizes are offered by the manufacturer and provided by the employer.”
Dr. Dr. Galina Fisher, representative of the Committee of Female Doctors in the Hartmannbund, notes that female doctors in the “traditionally male-dominated medical working world” are confronted with a lack of suitable sizes of protective clothing. [7]
Studies have shown that current radiation protection PPE (personal protective equipment) does not adequately protect women’s breast tissue, as the area near the armpit (the so-called upper outer quadrant and the armpit – the most common site for breast cancer) remains unprotected. [8]
Representatives of the Committee of Female Doctors in the Hartmannbund Dr. Dr. Galina Fischer, Dr Lisa Rosch and Dr Sabine Wedekind point out the urgent need to improve the implementation of occupational health and safety regulations with regards to adequate protective clothing for female doctors. [7]
The specialists at MAVIG know first-hand the challenges that women in hospitals and clinics face when working with X-ray machines. After all, protective clothing has to be worn for several hours a day.
How did the idea for the Victoria collection come about?
„The MAVIG team for personal protective equipment consists mainly of female employees. We regularly try on our products to get a feel for the models. We have realised that the female body places different demands on the cut of the PPE,” says Simone Füsers, Head of PPE Production at MAVIG.
Anna-Luisa Uhlitz mentions that customer feedback has also indicated that the current cuts do not provide optimum protection for some women, despite the right size being selected. “So far, this has been counteracted by customised armholes and by combining them with sleeves or a bolero. However, this always means additional work and therefore additional costs for our customers,” says Anna-Luisa Uhlitz. “That is why we have developed a waistcoat specifically for the needs of women, with a slim fit, small armholes and an elasticated back,” explains Simone Füsers.
„The Victoria collection now goes one step further, as we have already realised that the breast tissue is sometimes exposed despite the correct apron size. It protects a woman’s breast tissue particularly well, as the armholes have been reduced in size,” says Anna-Luisa Uhlitz, explaining the advantages of the new collection. “On the other hand, the princess seams (longitudinal dividing seams for a close-fitting cut) in the front and the stretch insert in the back are designed so that the X-ray protective clothing adapts to the female figure. This closes the “gap” at the armhole. Ideally, the Victoria collection should also be combined with a bolero to protect the shoulder joint,” says Anna-Luisa Uhlitz.
What is the price of Victoria aprons/coats compared to regular MAVIG radiation protection?
„The Victoria collection costs the same as the MAVIG collection. It is therefore cost-neutral to opt for the female cut. It was particularly important to us (also during development), as men and women shouldn’t pay different prices for good protection,” explains Anna-Luisa Uhlitz.
[1] Chou LB, Johnson B, Shapiro LM, Pun S, Cannada LK, Chen AF, et al. Increased Prevalence of Breast and All-cause Cancer in Female Orthopaedic Surgeons. JAAOS Glob Res Rev [Internet]. 2022 May [cited 2022 Oct 31];6(5). Available from: https://journals.lww.com/10.5435/JAAOSGlobal-D-22-00031
[2] Chou LB, Chandran S, Harris AHS, Tung J, Butler LM. Increased Breast Cancer Prevalence Among Female Orthopedic Surgeons. Journal of Women’s Health. 2012 Jun;21(6):683–9.
[3] Chou LB, Lerner LB, Harris AHS, Brandon AJ, Girod S, Butler LM. Cancer Prevalence among a Cross-sectional Survey of Female Orthopedic, Urology, and Plastic Surgeons in the United States. Women’s Health Issues. 2015 Sep;25(5):476–81.
[4] Sigurdson AJ, Doody MM, Rao RS, Freedman DM, Alexander BH, Hauptmann M, et al. Cancer incidence in the US radiologic technologists health study, 1983-1998. Cancer. 2003 Jun 15;97(12):3080–9.
[5] Jartti P, Pukkala E, Uitti J, Auvinen A. Cancer incidence among physicians occupationally exposed to ionizing radiation in Finland. Scand J Work Environ Health. 2006 Oct;32(5):368–73.
[6] Valone LC, Chambers M, Lattanza L, James MA. Breast Radiation Exposure in Female Orthopaedic Surgeons. The Journal of Bone and Joint Surgery. 2016 Nov 2;98(21):1808–13.
[8] Pilkington I, Sevenoaks H, James E, Eastwood D, Protecting female healthworkers from ionising radiation at work. BMJ. 2023; doi: https://doi.org/10.1136/bmj-2023-075406