不同职业放射暴露环境工作人员染色体和微核发生变化的影响因素分析

Factors influencing the changes of chromosome and micronucleus among workers exposed to different occupational radiation environments

目的探讨不同职业放射暴露环境工作人员外周血淋巴细胞染色体发生畸变和微核发生变化的危险因素,为评价各类职业放射暴露环境工作人员健康水平提供依据。方法收集2012年宝鸡市372名职业放射暴露环境工作人员(医用X线诊断139名,工业探伤106名,烟厂卷接工95名,工业同位素应用32名)的一般人口学、工龄、职业放射暴露环境及染色体和微核变化的数据。采用χ^2检验、多因素logistic回归等方法进行统计分析。结果不同年龄组职业放射暴露环境工作人员的微核率之间差异有统计学意义(P<0.05)。不同工龄组的ace畸变率、染色体型畸变率、染色体畸变总率和微核率之间差异有统计学意义(P<0.001);不同职业放射暴露环境工作人员的无着丝粒断片(acentricfragment,ace)畸变率和染色体型畸变率差异有统计学意义(P<0.05)。年龄和放射工龄是职业放射暴露环境工作人员发生ace畸变(OR=1.064,95%CI:1.018~1.112)、染色体型畸变(OR=1.064,95%CI:1.021~1.108)、染色体总畸变(OR=1.038,95%CI:1.006~1.071)和外周血淋巴细胞产生微核(OR=1.064,95%CI:1.037~1.091)的危险因素,随着年龄和放射工龄增加,其发生ace畸变、染色体型畸变、染色体总畸变和外周血淋巴细胞产生微核的风险增加。烟厂卷接工的放射暴露环境是发生染色体型畸变、染色单体畸变和染色体总畸变的危险因素。烟厂卷接工发生ace畸变、染色体型畸变、染色单体畸变和染色体总畸变的危险分别是医用X线诊断的3.679(95%CI:1.310~10.335)、3.637(95%CI:1.405~9.413)、3.649(95%CI:1.488~8.951)、3.794(95%CI:1.795~8.017)倍。人均年有效剂量与职业放射暴露环境工作人员外周血淋巴细胞发生变化无关。结论职业放射暴露环境对工作人员的外周血淋巴细胞产生一定的影响。年龄和放射工龄也与外周血淋巴细胞发生改变有关。与其他职业放射暴露环境相比,烟厂卷接工作环境是外周血淋巴细胞发生改变的主要危险因素。

Objective To explore the risk factors of chromosome aberration and micronucleus changes in peripheral blood lymphocytes of workers exposed to different occupational radiation environments so as to provide a basis for evaluating the health status of workers exposed to different occupational radiation environments.Methods We collected the data regarding general demography, length of service, occupational radiation exposure environment, and the changes of chromosome and micronucleus of 372 workers exposed to occupational radiation (including 139 workers exposed to medical X-ray, 106 exposed to industrial flaw detection, 95 exposed to coiling in cigarette factory , and 32 exposed to industrial isotope) in Baoji City in 2012. Chi-square test and multivariate logistic regression were used for statistical analyses.Results There were statistically significant differences in the micronucleus rate among occupational radiation exposure workers with different ages (P<0.05), in the acentric fragment aberration rate, chromosome pattern aberration rate, total chromosome aberration rate and micronucleus rate among workers with different length of service (P<0.01), and in the acentric fragment aberration rate and the chromosome pattern aberration rate among workers exposed to different occupational radiation environments (P<0.05). Age and working years with professional radiation were the risk factors for the occurrence of acentric fragment aberration(OR=1.064, 95%CI:1.018-1.112), chromosome pattern aberration(OR=1.064, 95%CI:1.021-1.108), the total chromosome aberration (OR=1.038, 95%CI:1.006-1.071) and micronucleus in peripheral blood lymphocytes (OR=1.064, 95%CI:1.037-1.091), and all the above-mentioned risks increased with the increasing age and length of radioactive service. Exposure to coiling in cigarette factory was the risk factor for the occurrence of chromosome pattern aberration, chromatid aberration and the total chromosome aberration (P<0.05). The risk ratios of occurring acentric fragment aberration, chromosome pattern aberration, chromatid aberration and the total chromosome aberration in the tobacco factory group were respectively 3.679 times(95%CI:1.310-10.335), 3.637 times(95%CI:1.405-9.413), 3.649 times(95%CI:1.488-8.951) and 3.794 times(95%CI:1.795-8.017)those of the medical X-ray group. The annual average effective exposure dose was not relevant to the changes in peripheral blood lymphocytes of the workers exposed to occupational radiation.Conclusions Occupational radiation exposure environment has certain effects on peripheral blood lymphocytes of the exposed workers. Age and length of radioactive service are also associated with the changes of peripheral blood lymphocytes. Compared with other occupational exposure categories, exposure to coiling in cigarette factory is a major risk factor for the changes of peripheral blood lymphocytes.