放射诊疗工作人员甲状腺疾病检出情况及危险因素分析

Studying the prevalence and risk factors for thyroid diseases among radiation-exposed workers

目的以多因素分析法分析放射诊疗工作人员甲状腺疾病检出的危险因素。方法2019年2月至2020年3月,选择某市16家医院放射诊疗相关医护人员615人进行研究。收集可能影响甲状腺疾病检出情况的因素,依据《中国甲状腺疾病诊治指南》进行诊断,根据有无甲状腺疾病分为2组,比较可能影响甲状腺疾病的各种因素,以多因素logistic回归法判断各因素的综合作用。结果从事放射诊疗工作的615医务人员中,检查出甲状腺疾病196人(31.87%)。单因素基础上的多因素分析结果显示,女性(OR=1.465,95%CI=1.012~2.122)、年龄增长(OR=1.484,95%CI=1.062~2.075)、有甲状腺疾病家族史(OR=1.514,95%CI=1.048~2.189)、三级单位(OR=1.542,95%CI=1.058~2.246)、工作年限延长(OR=1.456,95%CI=1.050~2.020)、技师(OR=1.490,95%CI=1.023~2.171)、碘不足(OR=1.523,95%CI=1.087~2.134)、碘过量(OR=1.514,95%CI=1.054~2.176)及个人剂量>15 mSv/a(OR=1.471,95%CI=1.040~2.081)为放射诊疗工作人员甲状腺疾病的危险因素,高级职称(OR=0.680,95%CI=0.512~0.904)为保护因素(P<0.05)。结论放射诊疗工作人员甲状腺疾病主要受工作人员性别、年龄、甲状腺疾病家族史、工作单位疾病、工作年限等因素的影响。

Objective Multi-factor analysis was used to analyze the risk factors for thyroid diseases among radiation-exposed workers.Methods From February 2019 to March 2020,615 medical personnel related to radiological diagnosis and treatment in 16 hospitals in Chengdu city were selected as subjects,and the data of risk factors for thyroid diseases was collected from the workers.The diagnosis of thyroid diseases was in accordance with the“Chinese guidelines for diagnosis and treatment of thyroid diseases”.According to the presence or absence of thyroid disease,the patients were divided into two groups,and the status of risk factors for thyroid disease were compared between these two groups.The role of risk factors in the prevalence of thyroid diseases was analyzed using the multi-factor logistic regression method.Results Among the 615 medical staff engaged in radiological diagnosis and treatment,196 were diagnosed with thyroid disease,accounting for 31.87%.The results of multivariate analysis on a single factor basis showed that female(OR=1.465,95%CI=1.012-2.122),increased age(OR=1.484,95%CI=1.062-2.075),family history of thyroid disease(OR=1.514,95%CI=1.048-2.189),three-level unit(OR=1.542,95%CI=1.058-2.246),extended working life(OR=1.456,95%CI=1.050-2.020),technician(OR=1.490,95%CI=1.023-2.171),iodine deficiency(OR=1.523,95%CI=1.087-2.134),iodine excess(OR=1.514,95%CI=1.054-2.176)and personal dose>15 mSv/a(OR=1.471,95%CI=1.040-2.081)were risk factors for thyroid diseases,and senior titles(OR=0.680,95%CI=0.512-0.904)was considered as a protective factor(P<0.05).Conclusions Thyroid diseases among radiation-exposed workers are mainly affected by factors such as gender,age,family history of thyroid diseases,workplace diseases,working years and other factors.