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太原市部分放射工作人员健康状况调查
【作者】 石建华；
【导师】 余红梅；
【作者基本信息】 山西医科大学 ， 流行病与卫生统计学， 2011， 硕士
【摘要】 目的：通过研究放射工作人员2002-2009年健康指标的动态变化情况,及2009年放射工作人员健康状况影响因素,了解低剂量电离辐射我市放射工作人员健康状况,为加强放射工作人员健康管理提供科学依据,并指导放射工作人员的辐射防护与健康促进。方法：2002-2009年放射工作人员职业健康档案和个人剂量档案均在太原市疾控中心备案。采用流行病学回顾调查的方法,分别通过对从事诊断放射学、核医学、工业探伤、放射性同位素应用等工种1350人次放射工作人员资料的收集,调查研究对象的一般情况,调查内容包括一般社会人口学、健康相关因素、职业相关因素等,及一般内科、皮肤、晶体、血常规、染色体畸变以及辅助检查。建立数据库,采用SPSS 13.0统计分析软件对资料进行整理、汇总、描述及分析。结果：(1)2002-2009年各健康效应指标未见明显规律性变化。(2)对2009年放射人员健康相关指标进行社会人口学、健康相关因素、职业相关因素的单因素分析,得出神经衰弱症候群、皮肤检查、血压、晶体、血常规、细胞遗传学、B超异常检出率在不同的单因素中差异有统计学意义。(3)多因素logistic回归分析结果表明,神经衰弱症候群的发生与吸烟、个人既往史和体质指数有关,吸烟频率越高,神经衰弱症候群发生的危险性越高；有个人既往史者或者正常体质指数正常者神经衰弱症候群发生的危险性增大。年龄是皮肤损害的危险因素,年龄越大,皮肤损害发生的危险性越高。血压异常与年龄、职称、个人既往史、体质指数、射线种类等因素有关,年龄越大、职称越高,血压异常发生的危险性就越大；有个人既往史者血压异常的危险性高于无个人既往史者；异常体质指数者血压异常的危险性高于正常体质指数者；γ线工作人员血压异常的危险性高于χ线工作人员。工龄对晶体混浊发生有影响,工龄越长,晶体混浊发生危险性越大。B超结果与性别、年龄和体质指数有关,男性B超结果异常的危险性高于女性；年龄越大,B超结果异常的危险性越大；异常体质指数者B超结果异常危险性高于正常体质指数者。结论：(1)目前,我市的辐射工作环境是安全的。低剂量电离辐射不会对放射人员身体健康造成影响。即在放射工作人员个人剂量大部分低于国家标准年限值1/10的情况下,其身体状况良好,未发现射线相关损伤。(2)高血压、脂肪肝等由现代生活方式等各种原因引起的困扰现代人的慢性疾病同样存在于放射工作人员中。(3)人们普遍关注的放射人员外周血象、淋巴细胞染色体畸变与职业因素无相关性。
【Abstract】 Objective:The aim of this study was (1) to investigate the physical condition of radiation workers in Taiyuan who works under low doses by analyzing dynamic changing of health indicators from 2002-2009 and the health effects of radiation in 2009; (2) to find a scientific way to strengthen the health management for radiation workers; and (3) to provide some suggestions and basis for establishing appropriate protective measures.Methods:2002-2009 radiation workers healthy records and personal files were recorded in Taiyuan CDC. By retrospective epidemiological survey, documents of 1350 radiation workers who worked in diagnostic radiology, nuclear medicine, industry detection and radioisotope applications were collected including social demographic, health and occupation related factors, some physical test for general medicine, skin, eye lenses, routine blood, chromosome aberration and assistant examination. The collected data were established, sorted, described and analyzed by SPSS 13.0.Results:(1) During 2002-2009, all health effect indicators showed no significant regular change. (2) Univariate analysis for the 2009 radiation workers including social demographic, health related and job related factors showed that there were significant differences among different factors in the detection rate of neurasthenic syndrome, skin check, blood pressure, crystal, blood routine, cell cytogenetic, B-anomaly. (3) Multivariate logistic regression showed that neurasthenic syndrome was related to smoking, personal medical history and BMI. Older age was a risk factor for abnormal skin. Abnormal blood pressure was related to older age, higher job title, personal abnormal blood pressure history, and abnormal BMI.γ-ray radiation workers had higher risk for abnormal blood pressure thanχ-ray radiation workers. Lens opacity was related to long length of service. B-anomaly detection rate was related to male, older age, and abnormal BMI.Conclusion:(1) At present, radiation on health status of radiation workers is safe, and low-dose radiation has little effect. In other words, the radiation workers are in good health and have no rays related injuries when most person-doses are less than one-tenth of the national standards.(2) Some chronic diseases, such as hypertension and fatty liver which often caused by modern life styles, also occur in radiation workers.(3) Researchers general interested routine peripheral blood and lymphocyte chromosome aberration are not associated with occupational factors.