2017—2019年上海市杨浦区医疗机构放射工作人员外周血象分析

Peripheral blood indicators in medical radiation workers in Yangpu District of Shanghai,2017−2019

【目的】探讨职业性电离辐射对医疗机构放射工作人员外周血象(白细胞、红细胞、血红蛋白和血小板)的影响。【方法】选取上海市杨浦区237名医疗机构放射工作人员为研究对象,依照外照射年个人有效剂量均值分为观察组和对照组,观察组年个人有效剂量为0.3577~4.7043 mSv,平均剂量为0.5368(0.4412~0.8938)mSv;对照组年个人有效剂量为0.0312~0.3508 mSv,平均剂量为0.1992(0.1438~0.2528)mSv。收集两组2017—2019年2次职业健康检查中外周血象的检查结果,采用χ^(2)检验、Mann-Whitney U检验、广义估计方程分析低剂量电离辐射对外周血象的影响。【结果】与首次体检相比,工作人员末次体检血红蛋白异常的风险升高(OR=1.029,95%CI:1.006~1.053),在控制了年龄、性别、工龄、时间等因素的影响后发现,观察组血红蛋白异常的风险比对照组低(OR=0.422,95%CI:0.198~0.898),白细胞、红细胞、血小板异常的风险未见统计学意义。【结论】职业性电离辐射会增加医疗机构放射工作人员的血红蛋白异常的风险,而白细胞、红细胞、血小板未见明显变化,工作人员在工作期间需注重个人防护,做好职业健康管理。

[Objective]To explore the impact of occupational ionizing radiation exposure on blood indicators including white blood cell(WBC),red blood cell(RBC),hemoglobin(Hb),platelet(PLT)were analyzed.[Methods]A total of 237 medical radiation workers in Yangpu district,Shanghai were recruited and divided into observation group and control group,according to individual average dose of external exposure.The annual effective dose in observation group was 0.3577-4.7043 mSv,and the median dose was 0.5368 mSv(0.4412-0.8938).The annual effective dose in control group was 0.0312-0.3508 mSv,and the median dose was 0.1992 mSv(0.1438-0.2528).Routine blood tests were conducted twice in the occupational health examinations from 2017 to 2019 and the results were collected.Chi-square test,Mann-Whitney U test,and generalized estimating equations(GEE)model were used for statistical analysis.[Results]Compared to the first examination,the risk of having abnormal Hb increased(OR=1.029,95%CI:1.006-1.053).After adjusting the factors of age,gender,seniority and exposure time,the risk of Hb abnormality in the observation group was lower than that in the control group(OR=0.422,95%CI:0.198-0.898).There was no significant difference between the observation and control groups in the risk of abnormal WBC,RBC,and PLT.[Conclusion]Exposure to occupational ionizing radiation may increase the risk of abnormal Hb,while there is no significant change in WBC,RBC and PLT.Radiation workers should have full protection at work and be under appropriate occupational health management.