医用放射工作人员全血细胞及遗传学影响因素分析

Analysis of whole blood cells and genetic influencing factors in medical radiation workers

目的:探索医用放射工作人员全血细胞及遗传学的影响因素,为完善职业健康管理,加强辐射防护提供技术支撑。方法:于2022年1月,选取2020年1月至2021年12月在甘肃省疾病预防控制中心进行职业健康检查的4 180名医用放射工作人员为研究对象,对其人口学特征、全血细胞、染色体畸变、淋巴细胞微核等结果进行收集,比较不同人口学特征医用放射工作人员的全血细胞及遗传学异常情况,用多因素logistic回归分析全血细胞及遗传学异常的影响因素。结果:核医学组放射工作人员血红蛋白(HGB)、染色体畸变、淋巴细胞微核异常率最高,放疗组放射工作人员白细胞(WBC)异常率高于其他职业类别组,差异有统计学意义( P<0.05);女性放射工作人员WBC、HGB、淋巴细胞微核异常率明显高于男性,差异有统计学意义( P<0.001);不同工龄、不同年龄放射工作人员的HGB、淋巴细胞微核异常率差异有统计学意义( P<0.001),不同工龄放射工作人员血小板(PLT)异常检出率差异有统计学意义( P<0.05);不同医院级别放射工作人员HGB异常率差异有统计学意义( P<0.001)。多因素logistic回归分析结果显示,女性放射工作人员WBC、HGB异常风险分别是男性的3.048、13.122倍( P<0.001);工龄6~20年、>20年组放射工作人员WBC异常风险分别是工龄≤5组的1.517、1.874倍( P<0.05);工龄>20年组放射工作人员PLT异常风险是工龄≤5年组的2.643倍( P<0.05);放疗组、介入组放射工作人员的WBC异常风险分别是普放组的2.407、1.341倍( P<0.05)。 结论:电离辐射对核医学、介入组、放疗组工作人员全血细胞及遗传学指标有不同程度的影响,应重点关注女性放射工作人员的职业健康防护。

Objective To explore the influencing factors of whole blood cells and genetics of medical radiation workers,and provide technical support for improving occupational health management and strengthening radiation protection.Methods In January 2022,a total of 4180 medical radiation workers who underwent occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 2020 to December 2021 were collected as the research objects,and the results of demographic characteristics,whole blood cells,chromosome aberrations,lymphocyte micronucleus and other results were collected.The whole blood cells and genetic abnormalities of different demographic characteristics of medical radiation workers were compared.And the influencing factors of whole blood cells and genetic abnormalities were analyzed by multivariate logistic regression.Results The rates of hemoglobin(HGB),chromosome aberration and lymphocyte micronucleus abnormality were the highest in the nuclear medicine group,and the rate of white blood cell(WBC)abnormality in the radiotherapy group was higher than those in other occupational groups,the differences were statistically significant(P<0.05).The abnormal rates of WBC,HGB and lymphocyte micronucleus in female radiation workers were significantly higher than those in male radiation workers(P<0.001).The abnormal rates of HGB and lymphocyte micronucleus were statistically different among different working years and different age radiation workers(P<0.001).And the abnormal rate of platelet(PLT)was statistically different among different working years radiation workers(P<0.05).The abnormal rate of HGB in radiation workers of different hospital levels was statistically different(P<0.001).Logistic regression analysis showed that the risk of abnormal WBC and HGB in females radiation workers were 3.048 times and 13.122 times of those in males,respectively(P<0.001).The abnormal risks of WBC in the 6-20 working years group and>20 working years group were 1.517 times and 1.874 times of that in the≤5 working years group,respectively(P<0.05).The abnormal risk of PLT in the>20 working years group was 2.643 times of that in≤5 working years group(P<0.05).The abnormal risk of WBC in radiotherapy group and intervention group were 2.407 times and 1.341 times of that in general radiotherapy group,respectively(P<0.05).Conclusion Ionizing radiation has different effects on the whole blood cells and genetic indexes of workers in the nuclear medicine,interventional group and radiotherapy group.The occupational health protection of female radiation workers should be paid attention to.