电离辐射对放射工作人员血象的影响

EFFECT OF IONIZING RADIATION ON HEMOGRAM OF RADIOLOGIC WORKERS

目的通过对放射工作人员辐射剂量进行监测，探讨电离辐射对放射工作人员外周血象的影响。方法采用流行病学中队列研究的方法，选取唐山市内1392名放射工作人员作为观察组，选取无射线接触史且其他条件与观察组具有可比性的143名身体健康者为对照组。分别进行一般情况调查、放射剂量测量、血常规检测。结果观察组白细胞（WBC）、红细胞（RBC）、血红蛋白（Hb）、血小板（PLT）均明显低于对照组，而淋巴细胞数（LY）、单核细胞数（MO）均高于对照组。按不同工种分组，观察组WBC、RBC、Hb、PLT分别依照放射诊断组、工业探伤组、工业放射源组、放免放疗组的次序呈现出明显的递减趋势，而LY、MO均呈现出明显的递增趋势。按不同工龄分析，观察组随放射工龄的增加，WBC、RBC、Hb、PLT在1～20年期间均降低，20年后随放射工龄的增加而升高，而LY和M0在1～20年期间均升高，20年后均降低。差异均有统计学意义（P〈0．05）。观察组WBC、RBC、Hb、PLT与累积辐射剂量均具有负相关性，而LY、MO与累积辐射剂量均具有正相关性。结论电离辐射对放射工作人员外周血象可产生一定程度的影响；放射工种不同，受到的辐射剂量不等，导致的辐射损伤程度也不同；辐射损伤与接触射线年限有关；外周血象各指标与累积辐射剂量均有一定程度的相关性。

Objective To explore the ionizing radiation effect on radiologic workers＇ peripheral hemogram through the radiation dose monitoring. Methods A casecontrol study was adopted in the study, 1392 radiation workers were selected as the observation group in Tangshan city and 143 physical healthy persons were selected as the control group which had better comparability with the observation group, General survey, radiation dose measurement, routine blood test were performed successively for all subjects. Results WBC, RBC, Hb, PLT in the observation group were significantly lower than those in the control group, while LY, MO were relatively higher than the control group. According to the order of medical diagnostic radiology groups, industrial inspection group, radioactive logging group and medical RIA radiotherapy group, WBC, RBC, Hb, PLT showed a decreasing trend, while LY, MO showed an increasing trend. Along with the increase of seniority, the radiation workers＇ peripheral blood indexes（WBC, RBC, Hb, PLT） decreased before 20a, and increased after 20a. While LY and MO increased before 20a, and decreased after 20a. The differences had statistical significance （P〈0.05）. The radiation workers＇ WBC, RBC, Hb, PLT had negative correlation with cumulative radiation dose, while LY, MO had positive correlation with cumulative radiation dose. Conclusions Ionizing radiation has influence on radiologic workers＇ health. The radio- logic workers engage in different types Of job are damaged by radiation distinctly, associated with the radiation exposure time. The radiation workers＇ peripheral blood indexes and cumulative radiation dose have a certain degree of correlation with each other.