| Currently, the use of flexible, light-weight, and environmentally friendly, nontoxic, lead-free polymer
composites with micro- and nano-metal fillers has attracted the attention of researchers for radiation
shielding applications. Lead toxicity and heaviness have oriented extensive research toward the use of nonlead composite shields. The present study aimed to systematically review the efficiency of the composite
shields of various micro- and nano-sized materials as composite shields have been considered in radiation
protection and diagnostic radiology. In addition, a meta-analysis was performed to determine the effects of
filler size, filler type, shield thickness and tube voltage on dose reduction. The relevant studies published since
2000 were identified via searching in databases such as Google Scholar, Medline, Web of Science, Scopus, and
Embase. In total, 51 articles were thoroughly reviewed and analyzed. Heterogeneity was assessed using the χ2
and I-square (I2) tests, and a fixed effects model was used to estimate the pooled effect sizes. The correlations
between the subgroups were determined separately using meta-regression analysis. According to the results,
the bismuth shield dose reduced from 22% to 98%, while the tungsten shield dose increased from 15%
to 97%. The rate also increased from 6% to 84% in the barium sulfate shields. The combination of two
metals resulted in higher attenuation against radiation, with the nano-shields exhibiting higher attenuation
compared to the micro-shields, especially in low energies. Moreover, the meta-analysis indicated that the
fixed effects pooled estimation of dose reduction was 89% for shield thickness (95% CI: 79-100; P<0.001),
73% for tube voltage (95% CI: 63-83; P<0.001; 50-100 kV), and 59% for tube voltage (95% CI: 35-82; P<0.001;
kV>100). The single-metal personal shields made of bismuth powder had better performance than tungsten
and barium sulfate. In addition, the combined metals in a shield showed more significant attenuation and
dose reduction compared to the single-metal shields. |