| 白江涛,高林峰,修增赫,王彬,王津晗,顾叶青.上海市医用X射线工作者肿瘤发病风险及流行病学研究[J].中华放射医学与防护杂志,2023,43(8):607-613 |
| 上海市医用X射线工作者肿瘤发病风险及流行病学研究 |
| The cancer risk and epidemiological analysis for medical X-ray workers in Shanghai |
| 投稿时间：2023-03-14 |
| DOI：10.3760/cma.j.cn112271-20230314-00074 |
| 中文关键词: 医用X射线工作者 队列研究 恶性肿瘤 相对危险度 |
| 英文关键词:Medical X-ray workers Cohort study Cancer Relative risk |
| 基金项目:中国医学科学院医学与健康科技创新工程（2019-I2M-2-006）；中国医学科学院医学与健康科技创新工程（2021-I2M-1-042）；上海市公共卫生重点学科建设计划项目（GWV-10.1-XK10） |
|
| 摘要点击次数: 1112 |
| 全文下载次数: 332 |
| 中文摘要: |
| 目的 研究医用X射线工作者的肿瘤发病风险，为职业受照人群肿瘤效应研究提供科学依据。方法 采用回顾性队列研究的方法，纳入上海市医疗机构1950—1980年间从事放射工作的715名医生为放射组，同时期同家医疗机构未从事放射工作的738名医生为对照组，收集调查对象的基本信息和肿瘤发病情况。计算该队列1980—2021年间累计观察人年数，采用logistic回归模型，计算调整性别、出生年份、开始工作年代等因素后放射组各种恶性肿瘤的相对危险度，并对性别等混杂因素进行放射组全癌发生风险的分层分析。结果 该队列共完成随访1 369人，其中放射组668人，对照组701人，总观察人年数为52 980人年。截至2021年12月31日，该队列恶性肿瘤患者共199人。logistic回归分析结果显示，放射组恶性肿瘤发病风险明显高于对照组，实体癌和全癌的调整相对危险度RR分别1.49（95%CI：1.08~2.05，P=0.015）和1.40（95%CI：1.02~1.92，P=0.036），其中放射组罹患甲状腺癌的相对危险度明显升高（RR=10.06，95%CI：2.05~49.62，P=0.005）。分层分析结果显示，在女性和开始工作年龄为21~25岁组中，放射组全癌发生风险高于对照组。结论 上海市医用X射线工作者罹患甲状腺癌、实体癌及全癌的相对危险度明显升高，提示该职业受照人群，特别是女性和开始工作年龄为低年龄组的人员应注意加强医疗实践活动中的辐射防护。 |
| 英文摘要: |
| Objective To study the risk of malignant tumor in medical X-ray workers in Shanghai and provide scientific data for the study on occupationally exposed population.Methods A retrospective cohort study was conducted to investigate the risk of cancer. Totally, 715 physicians in radiology departments during 1950-1980 in Shanghai were selected as exposure group, while 738 with non-radiology departments in the same hospital in the same time period as control group. The basic information on the selected physicians and associated cancer incidence were collected. The comulative number of individuals with cancer from 1980 to 2021 was calculated. The relative risk (RR) of cancer was analyzed using logistic regression model in terms of gender, birth year, and work starting year. As well, stratified analysis based on confounding factors was conducted.Results A total of 1 369 individuals were followed up, including 668 in exposure group and 701 in control group. The cumulative person-year of observed individuals was 52 980. As of 31 December 2021, a total of 199 patients with various malignant tumors were identified. The results of the logistic regression analysis showed that the risk of malignant tumors in exposure group was significantly higher than that in control group. The adjusted RR of solid cancer and total cancer was 1.49 (95%CI:1.08-2.05, P=0.015) and 1.40 (95%CI:1.02-1.92, P=0.036), respectively. In addition, the risk of thyroid cancer in exposure group was significantly higher than that in control group (RR=10.06, 95%CI:2.05-49.62, P=0.005). Stratified analysis showed that the exposure group had a higher risk of total cancer both for femals and workers taking their jobs at age of 21-25.Conclusions The risk of thyroid cancer, solid cancer and total cancer in the medical X-ray workers was significantly higher than that in control group. It is suggested that radiation protection in medical practice should be strengthened for the occupationally exposed workers, especially for femals and workers taking their jobs at low age. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|