| 魏鑫荻,王进,陈维,等.江苏省医用X射线诊断工作者肿瘤效应队列研究[J].中华放射医学与防护杂志,2024,44(10):841-848.Wei Xindi,Wang Jin,Chen Wei,et al.Cohort analysis of tumor effect for medical diagnostic X-ray workers in Jiangsu province[J].Chin J Radiol Med Prot,2024,44(10):841-848 |
| 江苏省医用X射线诊断工作者肿瘤效应队列研究 |
| Cohort analysis of tumor effect for medical diagnostic X-ray workers in Jiangsu province |
| 投稿时间：2024-04-25 |
| DOI：10.3760/cma.j.cn112271-20240425-00156 |
| 中文关键词: 医用X射线诊断工作者 肿瘤 辐射致癌 |
| 英文关键词:Medical diagnostic X-ray workers Tumor Radiation carcinogenesis |
| 基金项目:中国医学科学院医学与健康科技创新工程(2021-I2M-1-042);江苏省医学重点学科(JSZJ20232201) |
| 作者 | 单位 | E-mail | | 魏鑫荻 | 南京医科大学公共卫生学院, 南京 211166 | | | 王进 | 南京医科大学公共卫生学院, 南京 211166
江苏省疾病预防控制中心放射防护所, 南京 210009 | | | 陈维 | 江苏省疾病预防控制中心放射防护所, 南京 210009 | chenw@jscdc.cn | | 张子豪 | 南京医科大学公共卫生学院, 南京 211166 | | | 缪雨季 | 江苏省疾病预防控制中心放射防护所, 南京 210009 | | | 周媛媛 | 江苏省疾病预防控制中心放射防护所, 南京 210009 | | | 范向勇 | 江苏省疾病预防控制中心放射防护所, 南京 210009 | | | 王津晗 | 中国医学科学院放射医学研究所辐射损伤研究研究室, 天津 300192 | | | 顾叶青 | 中国医学科学院放射医学研究所辐射损伤研究研究室, 天津 300192 | |
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| 中文摘要: |
| 目的 本研究旨在探讨江苏省医用X射线诊断工作者长期接触X射线辐射对其肿瘤风险的影响,为制定职业防护政策和提高工作者健康水平提供科学依据。方法 采用回顾性和前瞻性队列相结合的研究方法,选取1950—1980年间在江苏省所有医院放射科工作的医用X射线诊断工作者为放射组;同医院同时期未从事过放射工作的内科、耳鼻喉科、儿科等医务人员为对照组,形成调查队列。计算该队列1950—2011年间累计观察人年数,采用Cox回归模型,计算调整性别、到达年龄、出生年代和开始工作年代等因素后医用X射线工作者的各种恶性肿瘤的相对危险度。结果 该队列共完成随访6 954人,其中放射组3 649人,对照组3 305人,总观察人年数为340 483人年。截至2021年12月31日,该队列恶性肿瘤患者共1 328人。Cox回归结果显示,与对照组相比,放射组罹患肺癌(RR=1.60,95%CI 1.24~2.08)、淋巴癌(RR=4.28,95%CI 1.54~11.93)、实体癌(RR=1.17,95%CI 1.04~1.31)、全癌(RR=1.29,95%CI 1.14~1.46)的相对危险度显著提高(Z=3.56、2.78、2.71、3.96,P<0.05)。分层分析结果显示,男性和61~岁的年龄组中,放射组罹患肺癌、淋巴癌、实体癌和全癌的风险高于对照组(χ2=6.70~33.86,P<0.05);开始工作年龄为21~25岁组中,放射组罹患肺癌、实体癌和全癌的风险高于对照组(χ2=6.46、6.16、5.62,P<0.05)。结论 江苏省医用X射线工作者罹患肺癌、淋巴癌、实体癌和全癌的相对危险度升高,提示应注意加强放射工作者在放射实践工作中的辐射防护。 |
| 英文摘要: |
| Objective To investigate the effects of long-term X-ray radiation exposure on the tumor risk of medical X-ray workers in Jiangsu province, and to provide a scientific basis for the development of occupational protection policies and the improvement of workers' health. Methods By using a combination of retrospective and prospective cohort research method, the medical diagnostic X-ray workers who worked in the radiology department of all hospitals in Jiangsu province between 1950 and 1980 were selected as the radiology group.In the meantime medical personnel in internal medicine, otorhinolaryngology, pediatrics and other medical departments who had not been engaged in radiology during the same period of time at the same hospital were selected as the control group to form a survey cohort. The cumulative number of person-years of observation of the cohort during 1950-2011 was calculated, and the relative risk of various malignant tumors among medical X-ray workers was calculated by using Cox regression model after adjusting for sex, attained age, year of birth, and year of work initiation. Results A total of 6 954 follow-ups was completed for the cohort, including 3 649 in the irradiation group and 3 305 in the control group, totally 340 483 person-years of observation. As of December 31,2021, there were 1 328 patients with malignant tumors in this cohort. Cox regression result showed that compared with the control group, the irradiation group who had developed lung cancer (RR=1.60, 95% CI 1.24-2.08), lymphoma (RR =4.28, 95% CI 1.54-11.93), solid cancer (RR =1.17, 95% CI 1.04-1.31), and total cancer (RR =1.29, 95% CI 1.14-1.46) had significantly higher relative risks (Z=3.56,2.78,2.71,3.96,P<0.05). Stratified analyses showed that the risks of lung, lymphoma, solid and total cancers were higher in the radiation group than in the control group for males and for those who arrived at the age of 61 years or older (χ2=6.70-33.86,P<0.05). The risks of lung, solid and total cancers were higher in the radiation group than in the control group for those who started to work in the age group of 21 to 25 years (χ2=6.46,6.16,5.62,P<0.05). Conclusions The relative risks of lung, lymphoma, solid and total cancers among medical X-ray workers in Jiangsu province are significantly higher, suggesting that attention should be paid to strengthening radiation protection for radiation workers in their radiological practices. |
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