Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus2-Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.

医用X射线诊断设备生产企业调试机房辐射水平测量及分析

目的:对医用X射线诊断设备生产企业的调试机房周围辐射水平进行检测,分析个别点位剂量率水平较高的原因,制定解决方案,以提高调试机房的辐射防护水平。方法:参照国家标准《医用X射线诊断放射防护要求》对北京地区具有代表性的医用X射线诊疗设备生产企业的医用X射线诊断设备调试机房周围辐射水平进行检测,对调试工程师的个人剂量进行监测,掌握调试机房外辐射水平和调试工程师的辐射防护情况。结果:检测的企业医用X射线诊断设备调试机房外辐射水平和调试工程师的个人剂量监测结果均符合国家标准的要求。结论:加强医用X射线诊断设备调试机房辐射防护的企业管理和政府监管,可有效降低调试机房周围辐射水平,并为做好调试工程师的辐射防护提供参考。

Measurement of the Effective Dose Radiation at Radiology Departments of Some Hospitals in Duhok Governorate

During operating of the X-ray machines, if the protection of X-ray rooms is insufficient, not only the patient but also clinical staffs as well as public are exposed to high X-ray dosage and they are affected from X-ray related to the dose level. In the present survey, by testing the radiological leakage and scatter from X-rays machines in radiology departments of 7 randomly selected hospitals in Duhok governorate, the effects dose of X-ray to the both control panel area and the patients waiting or visiting area who are located near the radiography room, were measured. The dose was recorded for a range of peak kilovoltage (kVp) and mAs values to find efficiency of shielding materials (barriers) of radiography rooms for different X-rays level. The measurements were performed at one meter above the ground surface which was the same height of X-rays tube by using Gamma Scout dosimeter. From the measurement results, it was seen that the most hospitals barriers (doors and walls) were not appropriate to the standards except 2 hospitals. The maximum effective doses were measured in uncontrolled area of Khazer hospital which was 82.48 ± 0.73 mSv·yr-1 that was much more than the reference dose limits and in controlled area of Haval Banda Zaroka hospital which was 12.98 ± 0.16 mSv·yr-1. In result, the knowledge about the radiation dose affecting the radiologists and public in the selected hospitals was obtained, and by informing the radiologists and the hospitals managements, the necessary regulations would be planned.

上海市2007—2011年医用X射线诊断机房放射防护监督抽检结果

[目的]评价目前上海市医用X射线诊断机房放射防护总体水平以及变化趋势。[方法]汇总上海市2007—2011年X射线影像诊断机房放射防护监督抽检全部数据并结合该时间段内该市放射防护监督管理工作开展情况进行分析。[结果]2007—2011年上海市医用X射线诊断机房放射防护监督抽检结果整体情况较好,抽检合格率为98.8%~100.0%;抽检的X射线影像诊断机房类型的分析结果发现,不合格点主要出现在医用X射线CT机房和医用X射线摄片机房;X射线影像诊断机房不合格点位置的分析结果发现,不合格点主要出现在候诊通道门、防护墙、控制室门和观察窗等位置。[结论]目前,上海市医用X射线诊断机房放射防护总体水平较好。通过持续的放射防护监管和监督抽检,可及时发现并纠正医疗机构放射防护管理工作中的不足。

医用诊断X射线机房放射防护现状调查

[目的]了解辖区医用诊断X射线机房的防护性能及存在的问题,为今后放射卫生监管提供依据。[方法]采用美国产451P型加压电离室巡测仪,按照国家标准GBZ 138—2002《医用X射线诊断卫生防护监测规范》等相关卫生标准进行放射防护情况检测。[结果]放射工作人员所在工作场所除控制室1个监测点剂量水平超标外,其余作业点基本达到了国家卫生标准的要求。而公众所在候诊区、机房防护门、防护墙、走廊的辐射剂量率监测超标数分别占31.82%、7.69%、9.42%和3.70%。31间X机房中14间机房X射线辐射剂量率超标,占监测机房总数45.16%。[结论]医疗单位放射防护工作有待进一步增强,依法管理是做好放射防护减少辐射危害发生的重要措施。

河北省医用X射线诊断卫生防护现状

目的调查河北省内省、市、县不同类型医院医用诊断X线机机房防护水平,检测使用中的X线机性能及防护水平,包括泄漏辐射及有用线束受检者入射体表空气比释动能率,以及医院受检者防护用品使用与配备现状。方法防护及泄漏辐射检测采用451P电离室巡测仪,受检者入射体表空气比释动能率检测采用Victoreen NEROTMmAx系统,防护用品使用与配备采取现场调查的方法。结果部分医院机房防护不合格,X线机泄漏辐射最高达1 100μSv/h,受检者入射体表空气比释动能率最大值达162 mGy/min,一次手术接受总剂量可达1.335 Gy,不能对受检者按要求进行合理防护的比例高达88.2%。结论河北省部分医院机房防护及X线机性能防护均存在很多问题,可能对医生及受检者健康造成损害。