Study On The Correlation Between Personal Dose Level Of Occupational External Irradiation And Health Index Level Of Radiation Workers In Medical Institutions

BackgroundAccording to the survey of the United Nations Scientific Committee on the Effects of Atomic Radiation(UNSCEAR),during the period from 2009 to 2018,about 4.2 billion radioactive inspections were conducted worldwide every year.The frequency of radiotherapy increased from 5.1 million times/year in 1997-2007 to 6.2 million times/year in 2009-2018.There are about 1.4 million patients treated by nuclear medicine every year in the world,and medical irradiation is the largest source of artificial ionizing radiation.With the continuous expansion of the application of radiation in medical and health fields,the radiation diagnosis and treatment of medical institutions in China has developed rapidly.There are more than 55,902 radiation clinics in China.with more than 353.141 radiation workers.The risk of occupational exposure of radiation workers in medical institutions also increases.Therefore,the effects of occupational exposure on the health of radiation workers deserve further study.With the deepening of the research on ionizing radiation,the long-term health effects of long-term exposure to low dose ionizing radiation(LDIR)and its protective strategies are becoming the focus of public health research worldwide.There are a lot of studies on the health effects of long-term exposure to LDIR at home and abroad,but there is still no consistent conclusion.Studies have shown that long-term LDIR can increase the risk of cancer.It has also been found that the biological effects induced by LDIR,including adaptive response and excitatory effect,have beneficial health effects on human body.At present,the epidemiological research object of LDIR in China is mainly radiation workers.It is found that long-term exposure to LDIR may have adverse effects on the health of radiation workers,such as abnormal liver function and liver enzymes,increased lens opacity and so on.Due to regional differences,the health risks of radiation professionals in different regions and countries may be different due to different protection conditions,workload and protection awareness.The sample size of most studies is small,and some studies are limited to the single analysis of personal dose monitoring level or occupational health,and the research mainly focuses on the single factor analysis of gender,age,radiation length of service,type of work,etc.,while there are few studies on the influence of personal exposure dose on occupational health indicators of radiation workers.ObjectivesBy collecting and analyzing the personal dose monitoring results and occupational health examination data of radiation workers in some medical institutions in Heze City,Shandong Province,we can understand the personal dose level and occupational health status of radiation workers in medical institutions in Heze City,and explore the correlation between the personal dose level and health index level of radiation workers,so as to provide scientific basis for studying targeted protection countermeasures and ensuring the health of occupational radiation workers.Subjects and methods1.Study populationIn this study,1748 radiation workers in medical institutions in Heze City,Shandong Province were taken as the research object,and their personal dose monitoring results and physical examination data from 2019 to 2021 were collected.According to the physical examination categories,radiation workers were divided into pre-job group and on-job group.2.MeasurementsLiF(Mg,P,Cu)thermoluminescence personal dosimeter was used to detect the occupational external radiation dose of radiation workers.To investigate the occupational health status of radiation workers,including general survey(such as gender,age,radiation length of service,past medical history,family history,occupational history,etc.)and physical examination items(such as liver function,renal function,blood routine and urine routine,etc.).3.DefinitionAccording to GBZ 98-2020 "Health Requirements and surveillance specifications for Radiation Workers",blood samples are collected and determined by professional institutions according to strict standards.If the detection index is not within the reference value of clinical medicine,it will be judged as abnormal.4.Statistical analysisUse Excel 2019 to establish a database,and use statistical software SPSS 26.0 for data analysis.Strictly enter and review the data.Measurement data were expressed by mean standard deviation(X±S),and independent sample t test was used for comparison between groups.The counting data were expressed by rate(%),and the comparison between groups was made by χ2 test.Taking health indicators as the dependent variable.after adjusting gender,age and length of service,the relationship between personal exposure dose of occupational external irradiation and health indicators of radiation workers was analyzed by multivariate logistic regression model.All statistical tests were conducted by bilateral test(test level α=0.05),and the difference was statistically significant(P<0.05).Results1.Analysis results of cardiovascular system indicatorsThe detection rate of abnormal blood pressure and electrocardiogram in on-the-job group was higher than that in pre-job group(P<0.001).After adjusting sex,age and length of service,multivariate logistic regression analysis showed that there was no significant correlation between the annual effective dose and cardiovascular system indexes such as blood pressure and abnormal electrocardiogram(P>0.05).2.Results of B-ultrasound index analysisThe detection rate of liver and kidney abnormalities in on-the-job group was higher than that in pre-job group(P<0.001;P=0.010).there was no significant difference in the detection rate of gallbladder abnormality between the on-the-job group and the pre-job group(P>0.05).After adjusting sex,age and length of service,multivariate logistic regression analysis showed that there was no significant correlation between the average effective dose and the abnormalities of gallbladder,liver and kidney detected by B-ultrasound(P>0.05).3.Results of liver function index analysisThe abnormal detection rate of gamma-glutamyl transpeptidase(GGT)in the on-the-job group was significantly higher than that in the pre-job group(P=0.006),and the abnormal detection rate of albumin(ALB)in the on-job group was lower than that in the pre-job group(P=0.030).There was no significant difference in the abnormal detection rate of other liver function test indexes between the on-job group and the pre-job group(P>0.05).After adjusting for sex,age and length of service,multivariate logistic regression analysis showed that the average effective dose per year was a risk factor for the abnormality of alanine aminotransferase(ALT)and GGT(OR=2.945,P=0.021;OR=2.865.P=0.025),but there was no statistical significance between it and other liver function test index anomalies(P>0.05).4.Analysis results of renal function indexesThere was no significant difference in the abnormal detection rate of creatinine(Cr)and blood urea nitrogen(BUN)between on-the-job group and pre-job group(P>0.05).After adjusting sex,age and length of service,multivariate logistic regression analysis showed that there was no significant correlation between the annual effective dose and renal function indexes Cr and BUN(P>0.05).5.Analysis results of blood routine indexesThe abnormal detection rate of red blood cell indexes in on-the-job group was higher than that in pre-job group(P=0.042),and there was no significant difference in the abnormal detection rates of other blood routine tests between on-job group and pre-job group(P>0.05).After adjusting sex,age and length of service,multivariate logistic regression analysis showed that there was no signifcant correlation between the annual effective dose and abnormal blood routine test indexes(P>0.05).6.Analysis results of urine routine indexesThe abnormal detection rate of glucose in the on-the-job group was higher than that in the pre-job group(P=0.043),and the abnormal detection rate of blood in the on-job group was lower than that in the pre-job group(P=0.017).There was no significant difference in the abnormal detection rates of other urine routine test indexes between the on-job group and the pre-job group(P>0.05).After adjusting for sex.age and length of service,multivariate logistic regression analysis showed that there was no significant correlation between the annual effective dose and abnormal urine routine test indexes(P>0.05).7.Dermatological index analysis resultsThe detection rate of nail longitudinal ridge in on-the-job group was significantly higher than that in pre-job group(P<0.001),and there was no significant difference in the detection rate of other dermatological indexes between on-job group and pre-job group(P>0.05).After adjusting for sex,age and length of service,multivariate logistic regression analysis showed that the average effective dose was a risk factor for nail longitudinal ridge(OR=7.230,P=0.009),but there was no statistical significance between it and other abnormal dermatological indexes(P>0.05).8.Ophthalmic index analysis resultsThe detection rate of lens opacity in on-the-job group was significantly higher than that in pre-job group(P<0.001).After adjusting sex,age and length of service,multivariate logistic regression analysis showed that there was no statistical significance between the annual effective dose and lens opacity(P>0.05).ConclusionsLong-term exposure to low-dose ionizing radiation may have some effects on cardiovascular system,B-ultrasound,liver function,blood routine,urine routine,skin,eye lens and other health indicators of radiation workers in medical institutions in Heze City.There is a positive correlation between personal exposure dose of occupational external irradiation and abnormal liver function index ALT,GGT and skin index nail longitudinal ridge abnormality.Radiation protection should continue to be strengthened.