医疗行业放射工作人员染色体畸变水平的影响因素分析

Influence factors of chromosomal aberration levels in radiation workers in hospitals

目的探索医疗行业放射工作人员染色体畸变的影响因素。方法采用随机抽样方法选取214例年龄和性别匹配的放射工作人员作为研究对象,包括放射诊断57例、放射治疗49例、核医学52例和介入放射学56例共4组。采用常规细胞遗传分析方法检测外周血淋巴细胞染色体畸变,分析对染色体畸变的影响因素。结果4种工种间放射工作人员间无着丝粒片段(ace)率、易位(t)率和染色体型总畸变率比较,差异有统计学意义(χ^2=9.906、19.965、32.824,P<0.05),其中介入放射学组和核医学组的ace率、t率和染色体型总畸变率高于放射诊断组(χ介入^2=4.711、10.798、10.845,P<0.05;χ^2核医学=3.853、7.674、7.708,P<0.05)和放射治疗组(χ介入^2=9.209、9.772、21.330,P<0.05;χ^2核医学=8.010、6.969、10.812,P<0.05)。不同工龄组间放射工作人员的t率和总畸变率存在差异(χ^2=7.706、6.667,P<0.05),不同年有效剂量组间的ace率、t率和总畸变率亦存在差异(χ^2=12.263、15.360、21.478,P<0.01),且t率和总畸变率随受照剂量的增加有升高趋势(r=0.347、0.263,P<0.01)。Poisson回归分析显示,工种和年有效剂量是影响染色体畸变水平的因素(核医学组、介入放射学组和0.5~1 mSv组的IRR=1.797、2.136、1.422,P<0.05)。结论介入放射学与核医学工作人员的染色体畸变水平相对较高,应加强对这两个工种从业人员的辐射防护。

Objective To explore the influence factors of chromosomal aberration levels in radiation workers in hospitals.Methods Two hundred and fourteen age-and sex-matched hospital radiation workers were recruited by stratified random sampling method.According to the job title,the individuals were divided into four groups including diagnostic radiology group(n=57),radiotherapy group(n=49),nuclear medicine group(n=52)and interventional radiology group(n=56).Chromosomal aberrations in peripheral blood lymphocytes from the subjects were measured using conventional cytogenetic analysis method,and the influence factors of chromosomal aberrations were analyzed.Results There was significant difference in the frequencies of acentric fragment,translocation and total chromosome-type aberrations among the four groups(χ^2=9.906,19.965,32.824,P<0.05),and the rates of aberrations were significantly higher in the interventional radiology group and the nuclear medicine groups than those in the diagnostic radiology(interventional group:χ^2=4.711,10.798,10.845,P<0.05;nuclear medicine group:χ^2=3.853,7.674,7.708,P<0.05)and the radiotherapy groups(interventional group:χ^2=9.209,9.772,21.330,P<0.05;nuclear medicine group:χ^2=8.010,6.969,10.812,P<0.05).The rates of translocation and total aberrations(χ^2=7.706,6.667,P<0.05)and the frequencies of acentric fragment,translocation and total aberrations(χ^2=12.263,15.360,21.478,P<0.01)were dependent on the length of service and the dose among different groups.The rates of translocation and total aberrations significantly increased along with exposure doses(r=0.347,0.263,P<0.01).Poisson regression analysis indicated that the job titles and annual effective dose partly affected the levels of chromosomal aberrations[IRR=1.797(nuclear medicine group),2.136(interventional group)and 1.422(0.5-1 mSv group);P<0.05].Conclusions The frequencies of chromosomal aberrations in the radiation workers of interventional and nuclear medicine groups remain higher levels in hospital,thus it is necessary to strengthen the radiation protection on these radiation workers.