Arizona Mandates New Radiation Protections in Hospital X-Ray Rooms

By 2027, 50% of cath labs must install radiation protection systems; mandatory lead aprons end in protected rooms, and rural hospitals receive $3 million in funding.

In one sentence

Arizona lawmakers advanced legislation requiring radiation protection systems in at least 50% of hospital procedure rooms by July 1, 2027, and allocating $3 million to rural hospitals, following testimony citing 97% radiation scatter exposure and reported >99% mitigation capability.

What changed

SB 1120 — Radiation Protection System Installation

Effective date: July 1, 2027

Requirement: Health care facilities that perform procedures involving real-time X-ray imaging must ensure at least 50% of procedure rooms are equipped with a radiation protection system.

Amendment (Warner, Jan 20, 2026 @ 3:44 p.m.): Removes outpatient surgical centers (ASCs) and other excluded institutions from the installation requirement, narrowing the mandate to facilities in scope.

SB 1118 — Rural Hospital Grant Program

Purpose: Establishes a Department of Health Services (DHS) grant program to assist rural hospitals with the cost of installing radiation protection systems.

Amendment (Warner, Jan 26, 2026 @ 10:37 a.m.):

Appropriates $3,000,000 from the State General Fund in FY 2027

Specifies grants apply to cardiac catheterization procedure rooms

The problem lawmakers were asked to address

Testimony focused on occupational exposure faced by clinicians working in cardiac catheterization laboratories, where procedures rely on real-time fluoroscopy.

Speakers described a system where modern clinical capability has advanced, but worker protection has not kept pace. For decades, the primary defense cited was the lead apron, described as heavy, incomplete, and associated with long-term injury.

Numbers that mattered in testimony

• 3% of the X-ray beam produces the image
• 97% is reflected as scatter into the room
• 20–30 lb lead aprons worn 10–14 hours per day (testimony)
• 50% of clinicians have posterior cataracts by mid-career (testimony)
• 25,000–50,000 chest X-ray equivalents to the face by mid-career (testimony)
• 31 interventional cardiologists died of brain tumors as of 2013; 85% left-sided (AJC study cited in testimony)
• Speaker stated this number has more than doubled (>60) since then (testimony)
• 6 of every 600 new physicians develop a life-threatening cancer
• 6% absolute increase in lifetime cancer risk (testimony)
• 55% reported they would leave the profession if conditions do not change (testimony)

Why lead protection was described as insufficient

Testimony emphasized that lead aprons:

• Weigh 20–30 pounds
• Are worn for long procedural days
• Do not cover the head, neck, face, arms, or legs
• Are associated with spinal, cervical, and neurologic injury
• Do not address the primary source of exposure: patient-reflected scatter

One speaker stated:

“The lead apron is less than a cure.”

How radiation exposure was explained to lawmakers

Witnesses described radiation entering the patient and then reflecting outward in approximately 360 degrees, making the patient the primary scatter source.

An analogy used repeatedly:

• Lead apron = Kevlar: heavy and limited coverage
• Radiation protection systems = shielding that covers both the source and scatter pathway

One comparison used in testimony:

“If I put your face under an X-ray machine and hit the button 25,000 to 50,000 times, I’d be arrested.”

Radiation protection systems (as described in testimony)

• Referred to as enhanced radiation protection devices/systems (ERPDs)
• Described as FDA-cleared
• Supported by peer-reviewed studies in cardiology journals (JACC, J-SCAI, Circulation cited)
• Reported to reduce occupational exposure by greater than 99%
• Described as allowing clinicians to shed lead aprons while maintaining protection
• Systems were described as commercially available and already installed in select Arizona hospitals

Cost context raised during hearings

Figures cited during committee discussion:

• $120,000–$149,000 per system (average cited in SB 1118 discussion)
• $150,000–$200,000 per system (broader range cited)
• SB 1120 hearing referenced ~$150,000 plus ~$30,000 for real-time dosimetry in some cases

Rural hospitals were repeatedly identified as least able to absorb these costs without assistance.

Workforce and access implications

Testimony emphasized:

• Cardiology training positions did not fill (statement on record)
• Occupational risk is discouraging entry into the specialty
• Women disproportionately avoid the field due to reproductive exposure concerns
• A projected shortage of clinicians as demand increases

One witness stated:

“Zero radiation is not aspirational. It is a moral imperative.”

What Hospital Administrators Should Do Next

1. Identify which procedure rooms use real-time X-ray imaging
2. Determine how many rooms fall under the 50% requirement
3. Review installation timelines relative to July 1, 2027
4. Assess eligibility for SB 1118 rural grants
5. Review existing lead programs and dosimetry practices
6. Plan capital budgets and compliance pathways

Closing

Arizona lawmakers advanced SB 1120 and SB 1118 based on testimony that occupational radiation exposure in cardiac procedure rooms presents measurable health risks and that technology exists to mitigate them. Facilities now have a defined timeline, and rural hospitals have a dedicated funding pathway to participate.

Learn more about clinician radiation safety