我国医用诊断X射线工作者1950年～1990年间恶性肿瘤危险分析

Risk analysis of malignant tumors among Chinese medical diagnostic X ray workers in 1950 1990.

目的提供小剂量慢性照射诱发人类恶性肿瘤的证据和有关规律。方法用Ｏ／Ｅ程序分析了我国２４个省、直辖市、自治区２７０１１名医用诊断Ｘ射线工作者和２５７８２名其他科医务人员１９５０～１９９０年间恶性肿瘤发病资料。结果Ｘ射线工作者的恶性肿瘤发病率显著高于对照医务人员（ＲＲ＝１．１，９５％可信限为１．０～１．２）。发病率明显增加的恶性肿瘤是白血病、皮肤癌、妇女乳腺癌、肝癌和食管癌，相对危险分别为：２．３，５．０，１．６，１．３和４．４。白血病危险的增高主要见于１９７０年前开始Ｘ射线工作和开始放射工作时年轻者。结论从Ｘ射线工作者恶性肿瘤的相对危险与工龄、参加Ｘ射线工作时年龄和时期分析表明，Ｘ射线工作者的白血病。

Objective\ To provide evidence and related patterns of formation of human malignant tumors induced by prolonged exposure to low level ionizing radiation.Methods\ The cancer incidence (1950 1990) among 27011 medical diagnostic X ray workers was compared with that among 25782 other medical specialists employed between 1950 and 1980 in China by means of O/E system.Results\ A significantly elevated risk of cancer was seen among diagnostic X ray workers(RR=1 1,95%CI=1 0 1 2, P <0 05 ).Significantly elevated risks were seen for leukemia and cancers of skin,female breast,liver and esophagus,the RR being 2 3 5 0,1 6 1 3 and 4 4,respectively.The RR for leukemia was higher for X ray workers who began employment before 1970 and also for those who were young when employment began.Conclusion\ The patterns of risk associated with length of service and with age and calendar year of initial employment suggest that the excesses of leukemia,skin cancer and female breast cancer were due to occupational exposure to X rays.