低剂量辐射暴露对医疗机构放射工作人员细胞遗传学指标影响因素分析

Analysis of influential factors of low-dose radiation exposure on cytogenetic indicators of radiation workers in medical institutions

目的通过对放射工作人员细胞遗传学指标的分析,探讨不同工种、剂量、工龄、年龄等对其遗传学指标的影响。方法选取4家省级医院的552名放射工作人员为研究对象,对其淋巴细胞微核及染色体结果进行分析。结果介入组、核医学组、放疗组染色体总畸变率高于普放组,差异有统计学意义(χ^(2)=28.089,P<0.01),微核率及微核细胞率介入组高于其他组(χ^(2)=10.189、10.429,P<0.05);年有效剂量>1 mSv染色体总畸变率明显高于其他剂量组(χ^(2)=11.690,P<0.05);染色体总畸变率与年龄呈正相关(IRR=1.283,χ^(2)=8.393,P<0.05);>20~30年工龄组、>40~50岁年龄组微核率及微核细胞率最高(χ^(2)=17.354、13.573、51.475、46.909,P<0.05)。Poisson回归分析结果显示,工种是染色体总畸变的影响因素,性别、年龄、工种是淋巴细胞微核率的影响因素。结论在加强核医学、介入放射工作人员健康监护的同时,放射治疗工作人员的职业状况也需要重点关注。

Objective To analyze the influential factors that affect how radiation workers in medical facilities respond cytogenetically to low-dose radiation exposure,the influence of different types of work,dosage,length of service,age,etc,on their cytogenetic indexes was discussed.Methods A total of 552 radiation workers from 4 provincial hospitals were selected as the research subjects,and their lymphocyte micronucleus and chromosome results were analyzed.Results The total aberration rate of chromosomes in the intervention group,nuclear medicine group,and radiotherapy group was higher than that in the general radiotherapy group,and the difference was statistically significant(χ^(2)=28.089,P0.01),and the rate of micronucleus and micronucleus cells in the intervention group were higher than those in the other groups(χ^(2)=10.189,10.429,P0.05);the total chromosome aberration rate of the annual effective dose1 msv was significantly higher than other dose groups(χ^(2)=11.690,P0.05);the total chromosome aberration rate was positively correlated with age(χ^(2)=8.393,P0.05);the 20-30 employed agegroup and the 40-50 age group had the highest rates of micronucleus and micronucleated cells(χ^(2)=17.354,13.573,51.475,46.909,P0.05).Poisson regression analysis showed that occupation was the influentialfactor of total chromosome aberration,and the gender,age and occupation were the influentialfactors of lymphocyte micronucleus rate.Conclusion While strengthening the health monitoring of nuclear medicine and interventional radiation workers,the occupational status of radiation therapy workers also requires our focus.