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目的:分析长期接触低剂量电离辐射对医疗职业人群甲状腺结节患病的影响及其影响因素,为该类人群的职业卫生防护提供依据。方法:以南京某三甲医院从事放射诊疗工作的人群为暴露组,以某企业未接触辐射的行政人员为对照组,通过问卷调查研究获取基本信息,通过疾控部门获取目标人群电离辐射的职业暴露剂量,采用彩色多普勒超声诊断仪检查甲状腺结节,运用Logistic回归模型分析相关影响因素。结果:两组人群在年龄、性别、工龄等方面具有较好的均衡性;暴露组人群辐射接触的剂量均低于国家限定值的1/10,属于低剂量暴露;暴露组甲状腺结节的异常率明显高于对照组,且随着人均年有效累计剂量和接害年限的增加出现显著增高趋势(P<0.05)。多因素Logistic回归分析也证实,年均有效累计剂量和接害年限均为甲状腺结节异常的独立危险因素,尤以年均累计有效剂量最为显著(OR=16.913,95%CI为2.212~129.336)。结论:长期接触低剂量电离辐射可引起医疗职业人群的甲状腺损伤,应当予以关注。
OBJECTIVE: To analyze the influence of long-term exposure to low-dose ionizing radiation on the prevalence of thyroid nodules and its influencing factors in medical occupational populations and provide the basis for occupational health protection in this population. Methods: The population engaged in radiotherapy and treatment in a top three hospital in Nanjing was exposed group. The control group was exposed to radiation without exposure to a certain enterprise. The questionnaires were used to obtain basic information. Occupational exposure to ionizing radiation Dose, color Doppler ultrasound diagnostic thyroid nodules, the use of Logistic regression model analysis of the impact of relevant factors. Results: There was a good balance between the two groups in terms of age, sex, length of service and so on. Exposure dose of exposure group was less than 1/10 of the national limit, which was a low-dose exposure. The abnormality of thyroid nodules The rate was significantly higher than that of the control group, and with the increase of per capita effective cumulative dose and duration of injury, there was a significant increase trend (P <0.05). Multivariate logistic regression analysis also confirmed that the cumulative average annual dose and duration of injury are independent risk factors for thyroid nodules, especially the annual average effective dose is most significant (OR = 16.913, 95% CI 2.212 ~ 129.336) . Conclusion: Long-term exposure to low doses of ionizing radiation can cause thyroid damage in medical professionals and should be of concern.