| 张素芬,刘小莲,王恰,郭玮珍,李明芳,刘庆凤,麦维基,陈慧峰.广东省医学放射工作人员眼晶状体异常影响因素分析[J].中华放射医学与防护杂志,2022,42(10):771-778 |
| 广东省医学放射工作人员眼晶状体异常影响因素分析 |
| Analysis of influence factors for lens abnormality for medical radiation workers in Guangdong province |
| 投稿时间：2022-01-26 |
| DOI：10.3760/cma.j.cn112271-20220126-00036 |
| 中文关键词: 电离辐射 放射工作人员 眼晶状体 |
| 英文关键词:Ionizing radiation Radiation workers Lens |
| 基金项目:广东省职业病防治重点实验室(2017B030314152);广东省化学中毒与核辐射突发事件医学救援应急技术研究中心(2016A020224005);广东省基础与应用基础研究基金 (2019A1515011969,2022A1515012421);广东省医学科研基金(C2020028,B2021386);广州市科技计划项目(202002030031) |
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| 中文摘要: |
| 目的 调查广东省医学放射工作人员电离辐射剂量水平和眼晶状体异常现况,分析眼晶状体异常的影响因素。方法 采用方便抽样方法抽取2020年广东省粤中和粤东地区60家医院的 1 501名放射工作人员作为研究对象,回顾性分析其眼晶状体吸收剂量(DL)和健康检查资料,分析眼晶状体异常的影响因素。结果 研究对象眼晶状体吸收剂量中位数M和第25~75百分位数(P25,P75)为4.86(2.99, 7.90)mGy,其中,男性和女性的剂量M分别为5.14和3.94 mGy; 一、二、三级医疗机构的剂量中位数分别为2.95、3.51、5.06 mGy;放射治疗、诊断放射学、介入放射学、核医学职业类别的剂量M分别为4.05、4.84、5.39、6.71 mGy; 护士、医师、技师岗位的剂量中位数分别为3.48、5.03、5.03 mGy。不同性别、年龄、放射工龄、接触放射起始年龄、医疗机构级别、职业类别、岗位的剂量差异均具有统计学意义(Z=-6.72,H=389.64、511.17、70.29、53.29、49.06、39.89,P<0.05)。研究对象眼晶状体皮质密度增高检出率22.45%(337/1 501),眼晶状体浑浊检出率为8.19%(123/1 501)。 皮质密度增高检出率随着年龄、放射工龄、接触放射起始年龄、医疗机构级别、DL增加呈线性递增趋势(χ2=366.36、313.77、15.18、21.61、92.13,P<0.05)。眼晶状体浑浊检出率随着年龄、放射工龄、医疗机构级别、剂量增加呈线性递增趋势(χ2=69.64、67.65、67.65、37.37,P<0.05),随着接触放射起始年龄增加呈线性递减趋势(χ2=4.25,P<0.05)。logistic回归分析结果显示,年龄是皮质密度增高的影响因素(χ2=165.98,P<0.05),年龄增加发生皮质密度增高的风险增高(OR=1.33,95%CI: 1.27~1.39)。年龄、放射工龄、职业类别是眼晶状体浑浊的影响因素(χ2=25.78、4.99、6.88,P<0.05)。年龄增加发生眼晶状体浑浊的风险增高 (OR=1.17,95%CI: 1.10~1.24);放射工龄增加发生眼晶状体浑浊的风险增高 (OR=1.06,95%CI: 1.01~1.12);介入放射学工作人员发生眼晶状体浑浊的风险高于放射诊断学、放射治疗与核医学(OR=2.59,95%CI: 1.27~5.25)。结论 长期接触低剂量电离辐射与医学放射工作人员眼晶状体异常检出率具有一定的相关性。年龄、放射工龄、职业类别均是眼晶状体浑浊的影响因素。 |
| 英文摘要: |
| Objective To investigate the exposure level of ionizing radiation in medical radiation workers in Guangdong province, as well as their abnormality in the lens of the eye, and to analyze associated influence factors.Methods In this study, 1 501 radiation workers from 60 hospitals were selected by using convenient sampling method for retrospecotive analysis of absorbed doses (DL) to the lens of the eye, health examination information and the relevant influence factors.Results The median value M and the 25th and 75th percentile values (P25,P75)of the distribution of absorbed doses were 4.86, 2.99 and 7.90 mGy, respectively. The median values for male and female were 5.14 and 3.94 mGy, respectively. The median values for the Levels I, Ⅱ and Ⅲ medical institutions were 2.95, 3.51 and 5.06 mGy, respectively. The median values were radiotherapy 4.05 mGy, radiodiagnosis 4.84 mGy, interventional radiology 5.39 mGy and nuclear medicine 6.71 mGy, as well as nurses 3.48 mGy, physicians 5.03 mGy and technologists 5.03 mGy, respectively. There were statistically significant differences in dose distribution for different gender, age, length of radiation service, age at the beginning of radiation exposure, level of medical institution, occupational category and post (Z=-6.72,H=389.64,511.17,70.29,53.29,49.06,39.89, P<0.05). The detectable rate for increased cortical density of lens was 22.45% (337/1 501) and for lens turbidity was 8.19% (123/1 501). The detectable rate of increased cortical density showed a linear increasing trend with the increase in age, age of radiation service, age at the beginning of exposure to radiation, level of medical institution and dose (χ2=366.36,313.77,15.18,21.61,92.13,P<0.05). The detectable rate of lens opacity increased linearly with the increase in age, length of radiation service, level of medical institution and dose(χ2=69.64,67.65,67.65,37.37,P<0.05), and decreased linearly with the increase in age at the beginning of radiation exposure (χ2=4.25,P<0.05). Logistic regression analysis showed that age was the influencing factor of increased cortical density (χ2=165.98,P<0.05), and the risk of cortical densification increased with age (OR=1.33,95%CI:1.27-1.39). Age, length of radiation service and occupation were the influencing factors of lens opacity (χ2=25.78,4.99,6.88,P<0.05). The risk of lens opacity increased with age (OR=1.17,95%CI: 1.10-1.24). The risk of lens opacity increased with age of radiation service (OR=1.06, 95%CI: 1.01-1.12). The risk of ocular opacity was higher in interventional radiology than that in diagnostic radiology, radiotherapy and nuclear medicine (OR=2.59,95%CI: 1.27-5.25).Conclusions Long-term exposure to low dose ionizing radiation has a certain correlation with the abnormal lens detectable rate of medical radiation workers. Age, length of radiation service and occupation are the influencing factors of lens opacity. |
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