广东省医学放射工作人员甲状腺异常情况及影响因素  

Thyroid abnormalities and influencing factors in medical radiology workers in Guangdong Province

作　　者：刘小莲[1] 张素芬[1] 郭玮珍[1] 李明芳 麦维基[1] 张灵钰 贾育新[1] 杨宇华[1] 陈慧峰[1] 黄伟旭[1] LIU Xiaolian;ZHANG Sufen;GUO Weizhen;LI Mingfang;MAI Weiji;ZHANG Lingyu;JIA Yuxin;YANG Yuhua;CHEN Huifeng;HUANG Weixu(Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangdong Key Laboratory of Occupational Disease Prevention and Control,Guangzhou,Guangdong 510300,China;School of Public Health,Guangzhou Medical University,Guangzhou,Guangdong 511495,China)

机构地区：[1]广东省职业病防治院,广东省职业病防治重点实验室,广东广州510300 [2]广州医科大学公共卫生学院,广东广州511495

出　　处：《环境与职业医学》2023年第3期323-330,共8页Journal of Environmental and Occupational Medicine

基　　金：广东省省级科技计划项目(2016A020224005,2017B030314152);广东省基础与应用基础研究基金(2019A1515011969,2022A1515012421);广东省医学科研基金(B2020119,C2020028,B2021386,C2021023);广州市科技计划项目(202002030031)。

摘　　要：[背景]甲状腺是对电离辐射敏感的器官之一,关于长期接触低剂量电离辐射对放射工作人员甲状腺影响的研究较少。[目的]调查广东省医学放射工作人员甲状腺检查异常情况,分析甲状腺异常可能的影响因素。[方法]采用方便抽样方法,抽取广东省48家医院共1657名放射工作人员作为调查对象,回顾性分析其个人剂量监测结果和健康检查资料,分析确定甲状腺异常可能的影响因素。[结果]1657名调查对象甲状腺吸收剂量(DT)的中位数和第25、75百分位数[M(P_(25),P_(75))]为1.55(0.65,3.96)mGy。诊断放射学、介入放射学、放射治疗、核医学职业类别放射工作人员的DT中位数M分别为1.29、1.38、1.99、3.51 mGy;护士、技师、医师岗位放射工作人员的DT中位数M分别为1.10、1.55、1.80 mGy。不同性别、年龄、放射工龄、接触放射起始年龄、职业类别、岗位的DT差异均具有统计学意义(Z=−6.35,H=708.52、918.20、31.19、95.64、39.28,P<0.05)。调查对象甲状腺异常率为46.53%(771/1657)。其中,甲状腺功能异常率22.87%(379/1657),甲状腺形态异常率为33.98%(563/1657),甲状腺结节检出率为26.55%(440/1657)。不同性别、年龄、放射工龄、接触射线起始年龄、DT、岗位放射工作人员的甲状腺异常率差异具有统计学意义(χ^(2)=51.89、49.64、20.54、18.29、12.07、16.16,P<0.05)。不同性别、接触射线起始年龄、岗位放射工作人员的甲状腺功能异常率差异具有统计学意义(χ^(2)=26.21、6.21、8.32,P<0.05)。不同性别、年龄、放射工龄、接触射线起始年龄、DT、岗位甲状腺形态异常率、结节检出率差异均具有统计学意义(甲状腺形态异常χ^(2)=40.24、64.17、37.63、15.17、19.28、15.05;结节χ^(2)=31.41、77.98、42.11、19.16、21.70、13.52,P<0.05)。甲状腺异常率、甲状腺形态异常率、结节检出率随着年龄、放射工龄、接触射线起始年龄增加均线性递增(P<0.05)。多[Background]The thyroid gland is one of the organs sensitive to ionizing radiation,and there are few studies on the effects of long-term exposure to low doses of ionizing radiation on the thyroid gland of radiation workers.[Objective]To investigate thyroid abnormalities in workers in medical radiology departments in Guangdong Province and to identify potential influencing factors of thyroid abnormalities.[Methods]A total of 1657 radiation workers from 48 hospitals in Guangdong Province were selected as survey subjects using convenience sampling,and their personal dose monitoring results and health examination information were retrospectively analyzed to determine the factors affecting thyroid abnormalities.[Results]The M(P_(25),P_(75))of thyroid absorbed dose(DT)was 1.55(0.65,3.96)mGy in the 1657 investigated workers.The attribute-specific medians of DT were 1.29,1.38,1.99,and 3.51 mGy for departments of diagnostic radiology,interventional radiology,radiotherapy,and nuclear medicine,respectively;and 1.10,1.55,and 1.80 mGy for job titles of nurse,technician,and physician,respectively.Differences in DT by gender,age,years of radiological work,age of radiation exposure onset,occupational category,and job title were statistically significant(Z=−6.35,H=708.52,918.20,31.19,95.64,39.28,P<0.05).The positive rate of thyroid abnormalities in investigated workers was 46.53%(771/1657).Among them,the positive rate of abnormal thyroid function was 22.87%(379/1657),that of abnormal thyroid morphology was 33.98%(563/1657),and that of thyroid nodule was 26.55%(440/1657).The differences in thyroid abnormality rates by gender,age,years of radiation work,age of radiation exposure onset,DT,and job title of radiation workers were statistically significant(χ^(2)=51.89,49.64,20.54,18.29,12.07,16.16,P<0.05).The differences in abnormal thyroid function positive rate by gender,age of radiation exposure onset,and job title were statistically significant(χ^(2)=26.21,6.21,8.32,P<0.05).The differences in the positive rates of abnormal thyr

关 键 词：电离辐射 医学放射工作人员 职业暴露 甲状腺异常 检出率 器官剂量 

分 类 号：R12[医药卫生—环境卫生学]