中国医用诊断X射线工作者1950—1995年恶性肿瘤危险分析

Risk analysis of malignant tumor among medical diagnostic X-ray workers in China,1950-1995

目的提供职业照射诱发人类恶性肿瘤的证据和评价其危害.方法用O/E程序分析了我国24省、直辖市、自治区1950～1980年间在职的27 011名医用诊断X射线工作者和25 782名其他科医务工作人员1950～1995年间的恶性肿瘤发病资料.结果 X射线工作者的恶性肿瘤发病率明显高于对照医务人员,相对危险(RR)为1.2,95%可信限(CI)为1.1～1.3.发病率明显增加的肿瘤是白血病、皮肤癌、女性乳腺癌、肺癌、肝癌、膀胱癌和食管癌;RR分别为:2.2、4.1、1.3、1.2、1.2、1.8和2.7.甲状腺癌的发病率也见增高RR=1.6,95%(CI)为0.9～2.6.结论 X射线工作者白血病、皮肤癌、女性乳腺癌,可能还有甲状腺癌相对危险的增高与职业X射线的照射有关,当累积剂量达到一定水平时,这些肿瘤的相对危险明显增高.

Objective\ To provide evidence of human malignant tumors induced by occupational exposure to ionizing radiation and to assess the resultant cancer risk. Methods\ Cancer incidence (1950-1995) among 27 011 medical X\|ray workers was compared by means of O/E system with that of 25 782 other medical specialists employed between 1950 and 1980 in China. Results\ Significant cancer risk was seen among medical X\|ray workers (RR=1 2,95% CI:1 1-1 3).Significantly elevated risks were found for leukemia and cancer of skin,female breast,lung,liver,bladder and esophangus,the RRs were 2 2,4 1,1 3,1 2,1 2,1 8 and 2 7,respectively.The RR of thyroid cancer also elevated but was not significant (RR=1 6,95% CI:0 9-2 6).The patterns of risk associated with number of years engaging in X\|ray work,age,the calendar year of initial employment,and cumulative dose,suggesting that the excesses of leukemia,skin cancer,female breast cancer,and possibly thyroid cancer,were related to occupational exposure to X\|rays. Conclusion\ These findings suggest that a significant cancer risk can be associated with occupational exposure to ionizing radiation when the cumulative dose reaches a certain level.