重庆市医用放射工作人员非癌发病探讨

Study on non-cancer incidence among medical radiation workers in Chongqing

目的研究职业X射线暴露对放射工作人员非癌疾病的影响。方法选取1980年普查四川省重庆市辖区内医用X射线工作者为调查对象。2020年, 选取之前的91家医疗机构, 分布在重庆市41个区县, 其中三级医疗机构53家, 运用前瞻性队列研究的方法, 第5次随访1980年重庆市医用X射线放射工作人员(放射组)和同医院同时期非放射科工作人员(对照组)的个人信息、职业射线接触情况、疾病史等信息。分析该队列各系统疾病发病率、各系统疾病相对危险度(RR)及其95%置信区间。结果该队列共计937人, 共统计非癌疾病359例。放射组与对照组相比, 其心血管系统、眼科和其他未分类疾病的相对危险度(RR)分别为1.50、2.03和2.64(χ^(2)=5.97、3.97、4.25, P <0.05)。调整混杂因素的结果显示, 女性放射组中心血管系统、眼科和消化系统等疾病发病率的RR普遍高于对照组(RR=2.33、2.59、7.55;χ^(2)=7.28、4.17、8.64, P<0.05);在25~29岁参加工作人员中, 放射组成员心血管系统、眼科等疾病发病率的RR普遍高于对照组(RR=2.26、5.07;χ^(2)=8.22、4.91, P<0.05);累积剂量分组中, 放射组与对照组比较, 心血管系统、眼科和消化系统等疾病发病率的RR普遍较高(RR=1.86、2.91、3.59;χ^(2)=9.83、8.21、5.58, P<0.05)。结论受到长期职业照射的X射线工作者非癌发病危险增高, 其中心血管系统、消化系统、眼科疾病等发病危险可能与这种职业照射有关。

Objective To study the effect of occupational X-ray exposure on non-cancer diseases of radiation workers.Methods The medical X-ray workers in Chongqing mumicipality were surved in 1980.In 2020,the previous 91 medical institutions distributed across 41 districts and counties of Chongqing continued to be selected as the survyed units,including 53 grade-A top-class hospitals.Using the method of prospective cohort study,the fifth follow-up survey was conducted for Chongqing′s medical X-ray workers and the control groups in 1980 with respect to their personal information,occupational radiation exposure,disease history and others.The incidence rate,relative risk(RR)and 95%confidence interval of diseases in each system were analyzed.Results There were 937 individuals in this cohort.So far,359 cases of non-cancer diseases had been counted.Compared with the control group,the relative risk RR of cardiovascular system,ophthalmology and other unclassified diseases in the exposure group were 1.50,2.03 and 2.64(χ^(2)=5.97,3.97,4.25,P<0.05),respectively.The adjusted confounding factors showed that the RR of the incidence rate of cardiovascular,ophthalmic and digestive diseases in the female exposure group was generally higher than that in the control group(RR=2.33,2.59,7.55;χ^(2)=7.28,4.17,8.64,P<0.05),respectively.The RR of the incidence rate of cardiovascular and ophthalmic diseases in exposure group was generally higher than that in the control group among 25-29 year-old workers(RR=2.26,5.07;χ^(2)=8.22,4.91,P<0.05),respectively.For compasion between the the accumulated dose groups,the incidence rate of cardiovascular system,ophthalmology and digestive system diseases in the exposure group was generally higher than that in the control group(RR=1.86,2.91,3.59;χ^(2)=9.83,8.21,5.58,P<0.05),respectively.Conclusions The non-cancer risk of X-ray workers exposed to long-term occupational exposure was increased,among which the risk of cardiovascular system,digestive system,ophthalmic diseases and others might be related to the occupational exposure.