新疆医疗机构放射暴露环境与职业健康防护水平分析

Radiation Exposure Environment and Occupational Health Protection Level in Medical Institutions in Xinjiang,China

目的了解新疆维吾尔自治区医疗机构放射工作人员健康管理状况,并提出相应的健康管理和服务措施。方法依据2019年国家职业性放射性疾病监测工作方案,收集新疆放射诊疗机构、放射职业健康检查机构和14个地州抽取的88家医院相关信息并对调查结果统计分析。结果共调查放射诊疗机构1314家,放射工作人员7255人,个人剂量佩戴率为96.14%,职业健康体检率为94.96%;调查88家医院中,三级医院14家(占比为15.91%),二级医院38家(占比为43.19%)、一级及未定级医院36家(占比为40.90%),地市级覆盖率为100%;放射工作人员中男性多于女性;防护用品配备率较高的为铅橡胶围裙,配备数量最少的为铅橡胶手套;不同等级医院在持证率、个人剂量建档率、个人剂量监测率、健康监护建档率及暂时脱离放射工作率上差异有统计学意义(χ^(2)值分别为42.97、54.93、42.02、40.79和29.32,P<0.001)。新疆职业健康体检机构共检查放射工作者体检结果显示,甲状腺彩超检查异常率为16.75%,外周血淋巴细胞染色体畸变率为0.02%,眼晶体浑浊率为0.47%。结论调查发现新疆地区医院放射工作人员的个人剂量和健康监护建档率存在地区差异,提示需要进一步加强相关地区职业健康管理和监督检查。

Objective To investigate the health management status of radiation workers in medical institutions in Xinjiang,China,and to put forward corresponding health management and service measures.Methods According to the China’s National Occupational Radiological Diseases Monitoring Work Plan in 2019,this survey collected relevant information from radiological diagnosis and treatment institutions,radiological occupational health examination institutions,and 88 hospitals selected from 14 prefectures in Xinjiang,and a statistical analysis was conducted for investigation results.Results A total of 1314 radiological diagnosis and treatment institutions were investigated,with 7255 radiation workers.The personal dose wearing rate was 96.14%,and the rate of occupational health examination was 94.96%.Among the 88 hospitals surveyed,there were 14 tertiary hospitals(15.91%),38 secondary hospitals(43.19%),and 36 primary or unspecified hospitals(40.90%),and the prefecture-level coverage rate was 100%.There were more male radiation workers than female workers.As for protective equipment,lead rubber apron had the highest equipment rate,and lead-rubber gloves were of minimum num-ber.There were significant differences in certificate holding rate,individual health care filing rate,individual dose monitoring rate,healthcare filing rate,and temporary radiation-free work rate among the hospitals at different levels(χ^(2) were 42.97,54.93,42.02,40.79,and 29.32,respectively,P<0.001).Among the radiation workers undergoing examination in Xinjiang occupational health examination institutions,the abnormal rate of thyroid color Doppler ultrasound was 16.75%,the chromosomal aberration rate of peripheral blood lymphocytes was 0.02%,and the lens opacity rate was 0.47%.Conclusion This investigation shows regional differences in individual dose and healthcare filing rates among radiation workers in hospitals of Xinjiang,suggesting that occupational health management and supervision should be further strengthened in related regions.