中华放射医学与防护杂志

刘宇飞,王福如,余宁乐,徐小三,程晓青,傅颖华,孙全富.江苏省医用X射线工作者1997—2011年队列随访恶性肿瘤发病危险分析[J].中华放射医学与防护杂志,2015,35(6):455-460

江苏省医用X射线工作者1997—2011年队列随访恶性肿瘤发病危险分析

Risk analysis of malignant tumor among medical diagnostic X-ray workers during 1997－2011 in Jiangsu province

投稿时间：2015-03-09

DOI：10.3760/cma.j.issn.0254-5098.2015.06.012

英文关键词:Medical X-ray workers Malignant tumor Radiation carcinogenesis

基金项目:卫生行业科研专项(201002009)

作者	单位	E-mail
刘宇飞	100088 北京, 中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室(现在中国医学科学院医学实验动物研究所)
王福如	江苏省疾病预防控制中心
余宁乐	江苏省疾病预防控制中心
徐小三	江苏省疾病预防控制中心
程晓青	100088 北京, 中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室
傅颖华	100088 北京, 中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室
孙全富	100088 北京, 中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室	qfusun@nirp.cn

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中文摘要:

目的对我国医用X射线工作者随访队列中最大的江苏亚组开展继续随访,分析1997—2011年队列随访期间慢性小剂量电离辐射照射诱发恶性肿瘤的发病危险。方法采用回顾性队列研究,由各市疾病预防控制中心按照统一随访方案,经过统一培训后,组织开展随访工作。采用Epicure之Datab计算随访队列1997—2011年累计观察人年分组列表,利用AMFIT进行分组资料的Poisson回归,计算调整性别、年龄等因素后医用X射线工作者的各种恶性肿瘤的相对危险(RR)值及其95%CI。结果共随访7 088人,其中,照射组3 668人,累计观察94 651.2人年,失访率为5.79%。在此期间诊断新发恶性肿瘤441例。与对照组相比,照射组全部恶性肿瘤的RR为1.44(95%CI:1.18~1.75),实体癌的RR为1.44(95%CI:1.18~1.75)。照射组发病率明显上升的恶性肿瘤包括肺癌(RR=1.95,95%CI:1.30~2.92)、食管癌(RR=3.04,95%CI:1.20~7.70)、淋巴癌(RR=2.24,95%CI:0.67~7.48)、白血病(RR=1.57,95%CI:0.33~7.39)、喉癌(RR=2.47)和甲状腺癌(RR=2.80,95%CI:0.24~32.26)。对失访情况进行调整后,照射组实体癌的RR=1.2(95%CI:0.94~1.46)。结论 1980年前参加工作的江苏省医用诊断X射线工作者恶性肿瘤,主要是肺癌、食管癌、甲状腺癌等恶性肿瘤的发病危险增高,可能与其接受的慢性小剂量电离辐射职业照射有关。

英文摘要:

Objective To continue following up the cohort members in Jiangsu province who were the largest subgroup in Chinese medical X-ray workers cohort subgroups on radiation carcinogenesis and analysis the cancer risk of medical X-ray workers which might be induced by chronic low-dose ionizing radiation between 1997 and 2011. Methods A retrospective cohort study was utilized to accumulate data. Epicure was applied to compute cumulative person years (with module of Datab) and relative risk(including 95%CI) of malignant tumor on exposed group(with module of AMFIT) while the factors such as sex and attained-age were adjusted in the cohort members. Results The 7 708 follow-up members included 3 668 medical X-ray workers. The cumulative person-year in the cohort members was 94 651.2 (1997-2011) and its lost rate was 5.79%. During the follow-up period, 441 cases had became cancer patients. The relative risk of all cancers was 1.44(95%CI:1.18-1.75), so was the solid cancers. Significant elevated risks of cancer were found on lung (RR=1.95, 95%CI:1.30-2.92), esophagus(RR=3.04, 95%CI:1.20-7.70), lymphoma(RR=2.24, 95%CI:0.67-7.48), leukemia(RR=1.57, 95%CI:0.33-7.39),throat(RR=2.47) and thyroid (RR=2.80,95%CI:0.24-32.26) among medical X-ray workers. However, The RR of malignant tumors might not be associated with occupational exposure to ionizing radiation if we considered the lost factors (RR=1.2, 95%CI: 0.94-1.46) Conclusions The RR of malignant tumors such as the cancer on lung, esophagus, thyroid among the medical X-ray workers in Jiangsu province were enhanced which might be associated with occupational exposure to ionizing radiation.

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