The use of ionizing radiation in healthcare has experienced steady growth over the past decades, both in terms of the number of diagnostic examinations and, particularly, in imaging-guided interventional procedures. The expansion of interventional radiology, interventional cardiology, and hybrid procedures has led to a significant increase in occupational exposure for healthcare professionals, especially in settings where fluoroscopy is used for prolonged or repeated periods. In this context, radiation protection can no longer be considered an accessory or purely individual measure, but a structural component of environment design and the organization of clinical workflows. The traditional approach to radiation protection, historically based on the use of personal protective equipment, has over time shown clear limitations, particularly in terms of ergonomics and operational sustainability. The increase in the average duration of procedures and frequency of exposure has made a comprehensive rethinking of protection strategies necessary, shifting the focus toward integrated and collective solutions.

Personal protective equipment (PPE), such as lead aprons, thyroid collars, and shielding glasses, still represents an essential element of radiation protection. However, relying solely on PPE has well-documented limitations. The high weight of leaded PPE is associated with an increased incidence of musculoskeletal disorders among operators, particularly affecting the spine and joints. Furthermore, the protection provided by PPE is limited to the covered body areas and heavily depends on correct donning and maintaining proper positioning during procedures. These limitations have driven a gradual shift toward collective protection systems, designed to reduce exposure at the source before the radiation reaches the operator. In this context, mobile radiological protection systems play a central role, allowing shielding to be integrated directly into the work environment without significantly interfering with clinical operations.

Mobile radiological protection systems are designed to create a shielding barrier between the radiation source and the operator, while maintaining visibility and freedom of movement. Unlike fixed shields, these devices offer flexible positioning and adaptability to different room layouts, making them particularly suitable for multifunctional environments such as hybrid rooms, interventional radiology suites, and operating rooms with integrated imaging. From a technical perspective, the effectiveness of a mobile system depends on a combination of factors: shielding material, lead-equivalent thickness, barrier geometry, height, and structural stability. The design must consider not only the attenuation of primary and scattered radiation but also the operational procedures and positions assumed by operators during the procedure.

X-ray radioprotective screens can be manufactured from various materials, selected based on the level of required protection, transparency, mechanical strength, and ease of handling. Shielding acrylic, optionally enriched with lead or other high atomic number elements, offers lightweight construction and ease of maneuverability, making it suitable for contexts where basic protection and frequent repositioning of the device are needed. However, the durability and optical quality of acrylic may be lower compared to other solutions, especially over the long term. Glass represents an alternative with better mechanical strength and visual quality. Its shielding capacity remains limited unless combined with high-attenuation materials, but it is suitable for applications where robustness and optical quality are priorities. Leaded glass provides the highest levels of radiological protection, combining excellent transparency, durability, and strength. Its greater mass suggests use in high-exposure contexts and for mobile devices designed for stable positioning during prolonged procedures, such as suspended screens or those integrated into the operating room.

The effectiveness of X-ray radiation protection systems does not depend solely on the characteristics of the shielding material or on the lead equivalence value, but decisively on their integration into the functional room layout and existing support systems. In highly technology-dense environments such as operating rooms with integrated imaging, hybrid rooms, and interventional radiology suites, radiological shielding introduces loads, volumes, and movement constraints that must be addressed at the design stage rather than treated as a subsequent add-on. In this context, radiation protection should be considered an integral part of the room’s technological infrastructure, on a par with surgical lights, monitors, imaging systems, and other suspended devices. Radioprotective screens, made of shielding acrylic, glass, or leaded glass, are not merely passive elements but devices that must be precisely positioned relative to the radiation source and the operator’s working posture. The ability to create shielding with customized geometries and dimensions allows protection to be adapted to the actual exposure field, improving effectiveness against scattered radiation while reducing unnecessary bulk. From a hospital engineering perspective, integrating shielding into articulated arm structures, single or multiple, represents a solution consistent with space optimization and operational safety principles. Ceiling- or wall-mounted suspended systems support the weight of the screen, ensuring balance and stability while providing a wide range of positioning freedom. The option to configure systems with two independent screens meets the needs of procedures in which multiple operators are simultaneously exposed to scattered radiation, enabling targeted protection without interfering with the visual field or clinical gestures. Another key design element is the integration of radiological shielding within multifunction suspended systems, shared with other medical devices such as surgical lights, monitors, cameras, or accessories, which helps reduce floor clutter, simplify workflow management, and improve the overall order of the working environment. In complex rooms where multiple devices and operators coexist, minimizing physical interference between equipment is critical for safety and operational efficiency. Mobile solutions on wheels represent a complementary expression of this integrated approach and are particularly suitable for multifunctional environments, rooms where structural modifications are not feasible, or settings in which room configurations frequently change; even in these cases, the design of the support system—stability, maneuverability, the ability to mount one or more screens, and compatibility with other devices in the room—directly influences the actual use of protection during procedures. Taken together, these solutions show that the transition from personal protection to collective radiological protection requires an integrated engineering approach in which shielding, support systems, and spatial organization are considered parts of a single system, allowing radiation protection to become a naturally incorporated element of the clinical gesture, always available and correctly positioned, rather than an operational constraint perceived as external or ancillary.

Yes, the propagation of X-rays in a clinical room is predictable within well-known margins, and it is precisely on this predictability that the design of radiological shielding is based. In medical procedures, the main contributor to operator exposure is not the primary beam, which is directed toward the patient and highly collimated, but the scatter radiation generated by the interaction of X-rays with the patient’s body and the table. This scattered radiation predominantly propagates::

• from the patient,
• with maximum intensity in directions close to the plane of the beam,
• with a spatial distribution that depends on the source geometry, the kVp, and the operator’s position.

Numerous dosimetric studies show that the operator is significantly exposed only in specific regions of space, typically between the source, the patient, and the working position. This makes it possible to intercept most of the dose with properly positioned shielding without having to fully enclose the space.

The transition from personal protection to collective and mobile radiological protection systems reflects a broader shift in how safety is approached in healthcare. Radiation protection becomes an integral part of room design and process organization, helping to create safer, more ergonomic, and sustainable working environments.