重庆市部分介入放射学工作人员眼晶状体的剂量监测与结果分析

Monitoring and results analyses of eye lens doses of some interventional radiology workers in Chongqing

目的调查重庆市3家医院部分介入放射学工作人员眼晶状体的受照剂量,分析相关的影响因素并提出降低当量剂量的对策。方法2020年6月至8月采用热释光剂量计对重庆市3家医院(2家综合性医院、1家肿瘤医院)的99名介入放射学工作人员眼晶状体的受照剂量进行监测,其中男性92名、女性7名,年龄20~40(30.0±6.2)岁,监测时间为1个月,根据监测结果估算眼晶状体的年当量剂量。采用Wilcoxon秩和检验比较介入放射学工作人员左、右眼晶状体当量剂量的差异;采用多元线性回归分析介入放射学工作人员左、右眼晶状体当量剂量的影响因素。采用独立样本Kruskal-Wallis H检验分析3家医院介入放射学工作人员不同手术类型左、右眼晶状体当量剂量总体分布的差异;采用Bonferroni法对不同手术类型左、右眼晶状体的当量剂量进行两两比较。结果3家医院99名介入放射学工作人员的左眼晶状体估算年当量剂量为5.38(2.46,13.10)mSv,右眼晶状体估算年当量剂量为3.54(1.55,8.48)mSv。其中有2名工作人员左、右眼晶状体的估算年当量剂量分别为42.72 mSv和48.00 mSv,接近国际辐射防护委员会单一年当量剂量限值50 mSv,但未超过我国眼晶状体年当量剂量限值150 mSv。3家医院介入放射学工作人员的左、右眼晶状体当量剂量的差异有统计学意义(Z=-5.599,P<0.001)。性别、吸烟习惯、手术曝光时间、仪器输出剂量对左、右眼晶状体的当量剂量无影响(β=-2.007~7.694,均P>0.05)。下肢静脉造影术与冠状动脉血管造影术、其他手术医护人员左眼晶状体当量剂量的差异均有统计学意义(H=24.115、39.569,均P<0.05),下肢静脉造影术与肝动脉化疗栓塞术、其他手术医护人员右眼晶状体当量剂量的差异均有统计学意义(H=23.719、39.347,均P<0.05)。结论重庆市3家医院部分介入放射学工作人员的估算年当量剂量均未超过现有国家标准。应注意下肢静脉造影术医护人员的排班情况、防护措施和健康监测。

Objective To investigated the dose of eye lens of some interventional-radiology workers in three hospitals in Chongqing,as well as to analyze the related factors and to put forward the countermeasures to reduce the equivalent dose.Methods A total of 99 interventional radiology workers(92 males and 7 females;aged 20-40(30.0±6.2)years)from three hospitals(two general hospitals and one cancer hospital)in Chongqing were included.They were monitored by thermoluminescence dosimetry for one month,and the annual equivalent dose of eye lens was estimated according to the number of surgeries.Wilcoxon rank sum test was used to compare the difference in lens equivalent dose between the left and right eyes of interventional radiology workers.Multiple linear regression was used to analyze the factors influencing lens equivalent dose in the left and right eyes of interventional-radiology workers.Kruskal-Wallis H test was used to analyze the difference in the overall distribution of lens equivalent dose of the left or right eyes of interventional-radiology workers in three hospitals with different operation types.Bonferroni method was used to compare the lens equivalent dose of left or right eyes with different operation types.Results For the 99 interventional radiologists in the three hospitals,the median estimated annual equivalent dose was 5.38(2.46,13.10)mSv for the left eyes and 3.54(1.55,8.48)mSv for the right eyes.The estimated annual equivalent dose of the lens in the left and right eyes of two radiation workers were 42.72 mSv and 48.00 mSv respectively,which were close to the International Commission on Radiological Protection's single annual dose limit of 50 mSv.They did not exceed the annual equivalent dose limit of 150 mSv for eye lens in China.A significant difference existed in the equivalent dose of lens in the left and right eyes of interventional-radiology workers in three hospitals(Z=-5.599,P<0.001).Among the influencing factors,gender,smoking habit,operation exposure time,and instrument output dose had no significant effect on the equivalent dose of left and right eyes(β=-2.007-7.694;all P>0.05).A significant difference existed in the equivalent dose of lens in the left eye between the lower extremity venography and coronary angiography or other operations(H=24.115,39.569;both P<0.05).A significant difference existed in the equivalent dose of lens in the right eye between lower extremity venography and hepatic artery chemoembolization or other operations(H=23.719,39.347;both P<0.05).Conclusions The estimated annual equivalent dose of some interventional-radiology workers in three hospitals in Chongqing did not exceed the existing national standard.Attention should be paid to the shift arrangement,protective measures,and health monitoring of medical workers in lower extremity venography operation.