职业性放射性疾病诊断标准在全国部分省市放射工作人员中的实施评估分析  

Evaluation and analysis on diagnostic criteria for common occupational radiation-induced diseases among radiation workers in some provinces and cities of China

作　　者：郭伟 赵风玲 邢志伟[2] 何玲[3] 刘伟 刘玉龙[5] 王守正 贺再清 陈维[8] 陈贵智 Guo Wei;Zhao Fengling;Xing Zhiwei;He Ling;Liu Wei;Liu Yulong;Wang Shouzheng;He Zaiqing;Chen Wei;Chen Guizhi(Henan Key Laboratory of Medicine on Radiobiology and Epidemiology,The Third People's Hospital of Henan Province(Henan Occupational Disease Hospital),Zhengzhou 450052,China;Department of Physical Examination,Institute of Radiation Medicine,Chinese Academy of Medical Sciences,Tianjin 300192,China;Department of Radiological Health,Sichuan Provincial Center for Disease Control and Prevention,Chengdu 610041,China;Office,Institute of Radiation Medicine,Shandong Academy of Medical Sciences,Shandong First Medical University,Jinan 250013,China;Department of Occupational Diseases,The Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Department of Occupational Diseases,No.417th Hospital of Nuclear Industry,Xi'an 710699,China;Office of Nuclear Emergency,No.416th Hospital of Nuclear Industry,Chengdu 610057,China;Department of Radiological Health,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Department of Radiological Health,Inner Mongolia Comprehensive Center for Disease Control and Prevention,Hohhot 010031,China)

机构地区：[1]河南省第三人民医院(河南省职业病医院)、河南省辐射生物与流行病学医学重点实验室,郑州450052 [2]中国医学科学院放射医学研究所健康检查科,天津300192 [3]四川省疾病预防控制中心放射卫生科,成都610041 [4]山东第一医科大学(山东省医学科学院放射医学研究所)办公室,济南250013 [5]苏州大学附属第二医院肿瘤职业病科,苏州215004 [6]核工业四一七医院职业病科,西安710699 [7]核工业四一六医院核应急办公室,成都610057 [8]江苏省疾病预防控制中心放射卫生科,南京210009 [9]内蒙古自治区综合疾病预防控制中心放射卫生科,呼和浩特010031

出　　处：《中华放射医学与防护杂志》2023年第8期620-626,共7页Chinese Journal of Radiological Medicine and Protection

基　　金：国家卫生健康委法规司卫生标准实施评估项目(20202105);河南省医学科技攻关计划项目(RKX202102015)。

摘　　要：目的对常见职业性放射性疾病诊断标准在放射工作人员中应用情况进行调查,为卫生标准的修订、宣贯和标准化管理提供依据。方法采用整群随机抽样的方法,在2021年1~5月对国家职业性放射性疾病上报系统信息中有上报病例的1市、7省、1集团的放射工作人员开展对标准的知晓、辐射健康效应和职业性放射性疾病诊断的认知情况及对诊断工作建议的调查并分析。结果2839名被调查放射工作人员,对不同诊断标准的知晓率、知晓标准的途径、复杂诊断标准中内容的知晓率、电离辐射不同效应概念的知晓率、申请职业性放射性疾病诊断所需材料的知晓情况存在差异(χ^(2)=416.06、2924.14、83.45、895.67、815.94,P<0.001)。对电离辐射确定性效应和随机性效应的正确理解率分别为80.63%和43.64%。对申请职业性放射性疾病诊断需要提供资料中职业病危害因素接触史、职业健康监护档案、个人剂量监测等资料认可率较高,分别为96.79%、94.72%、93.55%。参加过上岗前相关知识培训率80.20%,在岗期间培训率81.19%,未参加过任何培训3.77%。对职业性放射性疾病诊断工作建议较多的是加强培训,重视个人剂量监测、职业健康检查,强化卫生监督执法力度等。结论放射工作人员对部分诊断标准知晓率偏低,对诊断程序知晓率较高,仍要加强电离辐射健康效应及职业性放射性疾病诊断标准的宣贯、培训并不断优化职业性放射性疾病诊断程序。Objective To investigate the application of diagnostic criteria for common occupational radiation-induced diseases to radiation workers,in order to provide a basis for the revision,publicity and standardization of the standards.Methods Radiation workers were selected from 1 city,7 provinces and 1 corporation by using cluster random sampling method from January 2021 to May 2021.Awareness of the criteria and the effects of ionizing radiation,and the suggestions for diagnostic works were investigated and analyzed.Results A total of 2839 radiation workers were investigated.There were differences in the awareness of different diagnostic criteria,the inclusions in complex diagnostic criteria,the materials required for applying for diagnosis,and the ways of knowing the diagnostic criteria(χ^(2)=416.06,2924.14,83.45,895.67,815.94,P<0.001).The correct understanding rates of deterministic effects and stochastic effects were 80.63% and 43.64%,respectively.The acceptance rates in applicable materials were 96.79%for occupational exposure history,94.72% for occupational health monitoring records and 93.55%for individual monitoring of occupational exposure,respectively.Preemployment training rate was 80.20%,on-job training rate was 81.19%,and untrained rate was 3.77%.The suggestions to the diagnosis of occupational radiation-induced diseases are to strengthen training,pay attention to individual monitoring,occupational health examination,and strengthen health supervision and law enforcement.Conclusions Radiation workers have a low awareness rate of certain diagnostic standards and a high awareness rate of diagnostic procedures.Publicity and training of health effects of ionizing radiation and diagnostic criteria of occupational radiation-induced diseases should be strengthened.Diagnostic procedure should be optimized.

关 键 词：放射性疾病 卫生标准 放射工作人员 标准评估 问卷调查 

分 类 号：R14[医药卫生—公共卫生与预防医学]