重庆市第五次医用X射线工作者肿瘤效应流行病学调查分析

Fifth epidemiological investigation on tumor prevalence among medical X-ray workers in Chongqing,China

目的为研究医用X射线工作者肿瘤效应提供科学数据。方法采用队列研究的方法,采集重庆市医用X射线工作者及对照组个人射线接触史、肿瘤发病情况等信息;运用SPSS 24软件计算该随访队列肿瘤发病密度,计算队列人员各种恶性肿瘤的相对危险度(RR)及其95%置信区间。结果随访队列共934人,至调查截止共发生恶性肿瘤109例,与对照组相比,放射组肝癌和结直肠癌的RR都为3.4。修正放射组个人辐射累积剂量后,与累积剂量小于80 mGy和80~200 mGy两组相比,累积剂量大于200 mGy组实体癌的RR分别为2.05和2.1,累积剂量大于200 mGy组全癌的RR分别为1.89和2.17。结论重庆市医用X射线工作者较对照组罹患肝癌、结直肠癌的危险度较高,且个人辐射累积剂量中高剂量组罹患实体癌和全癌的危险度更高。因此,放射工作人员在放射工作实践中应注意防护的最优化。

Objective To provide scientific data for the study of tumor prevalence among medical X-ray workers.Methods In a cohort study,radiation exposure and tumor occurrence were collected from medical X-ray workers and nor-mal persons(control)in Chongqing,China.SPSS 24 software was used to calculate the incidence density of tumor in the fol-low-up cohort,as well as the relative risk(RR)and 95%confidence interval of various malignant tumors.Results A total of 934 subjects were followed up.By the end of the investigation,109 cases of malignant tumor were recorded.Compared with the control group,the RRs of liver cancer and colorectal cancer were both 3.4.Dose-specific RR was calculated for the worker groups.Compared with the two groups with<80 mGy and 80~200 mGy cumulative doses,the group with>200 mGy cumulative dose showed 2.05 and 2.1 RRs for solid cancer,and 1.89 and 2.17 RRs for whole cancer,respectively.Conclusion The risk of liver cancer and colorectal cancer is higher for medical X-ray workers in Chongqing,and the risk of solid cancer and whole cancer is higher in the high cumulative dose group.Therefore,radiation workers should pay atten-tion to the optimization of protection.