临床放射工作人员晶状体混浊及影响因素分析

Analysis of lens opacity and its influencing factors of medical radiation workers

目的探讨长期低剂量辐射暴露及其他影响因素与临床放射工作人员眼晶状体混浊风险关联。方法于2019年7月,采用回顾性队列研究的方法,整群抽取在广东省职业病防治院进行放射职业健康检查的22家广州市三甲医院的2 708名放射工作人员为研究对象。通过查阅2010至2018年广东省职业病防治院"职业健康检查信息系统"和"个人剂量监测系统",收集其基本人口学信息、各个监测周期外照射个人剂量结果和各年度放射职业健康检查中眼科检查结果,采用含时依协变量Cox模型对晶状体影响因素进行多因素分析。结果 2010至2018年放射工作人员晶状体混浊发病密度为185.90/万人年;与年龄<30岁组放射工作人员(93.74%)比较,年龄≥50岁组5年晶状体正常率(72.51%)更低,差异有统计学意义(P<0.01);与工龄<10年组放射工作人员(92.69%)比较,工龄≥20年组5年晶状体正常率(83.05%)更低,差异有统计学意义(P<0.01)。多因素分析结果显示,年龄是临床放射工作人员晶状体混浊的影响因素(HR=14.485,P<0.01)。与年龄<30岁组工作人员比较,30~岁组、40~岁组和50~岁组5年发生晶状体混浊风险分别增加4.9%、10.1%、15.5%。性别、吸烟、饮酒、工种、工龄和年均有效剂量对晶状体混浊影响均无统计学意义(P>0.05)。结论年龄是临床放射工作人员晶状体混浊的主要影响因素,应严格控制其放射工作时间和工作强度做好放射防护。

Objective To explore the association between long-term low-dose radiation exposure and other influencing factors with the risk of lens opacity on medical radiation workers.Methods In July 2019,a retrospective cohort study was conducted by collecting the basic demographic information,dose data and health inspection result of 2708 radiologists in 22 hospitals of Guangzhou from the Occupational Health Inspection Information System and the Personal Dose Monitoring System of the Guangdong Prevention and Treatment Center for Occupational Disease between 2010 to 2018.The association between the average annual effective dose and lens opacity risk was calculated by using Time-Dependent Cox Regression Model.Results From 2010 to 2018,the incidence density of lens opacity was 185.90/10000 person years.Compared with the radiation workers in the age<30 years group(93.74%),the 5-year normal rate of lens in the age≥50 years group(72.51%)was lower(P<0.01);Compared with the radiation workers in the exposure age<10 years group(92.69%),the 5-year normal rate of lens in more than 20 years exposed group(83.05%)was lower(P<0.01).Multifactor analysis showed that age was an independent influencing factor for lens opacity in medical radiation workers(HR=14.485,P<0.01).The risk of lens opacification increased by 4.9%,10.1%and 15.5%in 30-,40-and 50-years group,respectively.Gender,cigarette,alchol,type of work,length of service and annual effective dose had no significant effect on lens opacity(P>0.05).Conclusion Age is the main influencing factor of lens opacification in medical radiation workers,their radiation working time and intensity should be strictly controlled and radiation protection should be done.