中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2015年
6期
455-460
,共6页
刘宇飞%王福如%余宁乐%徐小三%程晓青%傅颖华%孙全富
劉宇飛%王福如%餘寧樂%徐小三%程曉青%傅穎華%孫全富
류우비%왕복여%여저악%서소삼%정효청%부영화%손전부
医用X射线工作者%恶性肿瘤%辐射致癌
醫用X射線工作者%噁性腫瘤%輻射緻癌
의용X사선공작자%악성종류%복사치암
Medical X-ray workers%Malignant tumor%Radiation carcinogenesis
目的 对我国医用X射线工作者随访队列中最大的江苏亚组开展继续随访,分析1997-2011年队列随访期间慢性小剂量电离辐射照射诱发恶性肿瘤的发病危险.方法 采用回顾性队列研究,由各市疾病预防控制中心按照统一随访方案,经过统一培训后,组织开展随访工作.采用Epicure之Datab计算随访队列1997-2011年累计观察人年分组列表,利用AMFIT进行分组资料的Poisson回归,计算调整性别、年龄等因素后医用X射线工作者的各种恶性肿瘤的相对危险(RR)值及其95％CI.结果 共随访7 088人,其中,照射组3 668人,累计观察94 651.2人年,失访率为5.79％.在此期间诊断新发恶性肿瘤441例.与对照组相比,照射组全部恶性肿瘤的RR为1.44(95％CI:1.18～1.75),实体癌的RR为1.44(95％ CI:1.18 ～ 1.75).照射组发病率明显上升的恶性肿瘤包括肺癌(RR=1.95,95％CI:1.30 ～2.92)、食管癌(RR=3.04,95％CI:1.20 ～7.70)、淋巴癌(RR =2.24,95％ CI:0.67 ～7.48)、白血病(RR=1.57,95％CI:0.33 ～7.39)、喉癌(RR=2.47)和甲状腺癌(RR=2.80,95％ CI:0.24～ 32.26).对失访情况进行调整后,照射组实体癌的RR=1.2(95％ CI:0.94 ～ 1.46).结论 1980年前参加工作的江苏省医用诊断X射线工作者恶性肿瘤,主要是肺癌、食管癌、甲状腺癌等恶性肿瘤的发病危险增高,可能与其接受的慢性小剂量电离辐射职业照射有关.
目的 對我國醫用X射線工作者隨訪隊列中最大的江囌亞組開展繼續隨訪,分析1997-2011年隊列隨訪期間慢性小劑量電離輻射照射誘髮噁性腫瘤的髮病危險.方法 採用迴顧性隊列研究,由各市疾病預防控製中心按照統一隨訪方案,經過統一培訓後,組織開展隨訪工作.採用Epicure之Datab計算隨訪隊列1997-2011年纍計觀察人年分組列錶,利用AMFIT進行分組資料的Poisson迴歸,計算調整性彆、年齡等因素後醫用X射線工作者的各種噁性腫瘤的相對危險(RR)值及其95％CI.結果 共隨訪7 088人,其中,照射組3 668人,纍計觀察94 651.2人年,失訪率為5.79％.在此期間診斷新髮噁性腫瘤441例.與對照組相比,照射組全部噁性腫瘤的RR為1.44(95％CI:1.18～1.75),實體癌的RR為1.44(95％ CI:1.18 ～ 1.75).照射組髮病率明顯上升的噁性腫瘤包括肺癌(RR=1.95,95％CI:1.30 ～2.92)、食管癌(RR=3.04,95％CI:1.20 ～7.70)、淋巴癌(RR =2.24,95％ CI:0.67 ～7.48)、白血病(RR=1.57,95％CI:0.33 ～7.39)、喉癌(RR=2.47)和甲狀腺癌(RR=2.80,95％ CI:0.24～ 32.26).對失訪情況進行調整後,照射組實體癌的RR=1.2(95％ CI:0.94 ～ 1.46).結論 1980年前參加工作的江囌省醫用診斷X射線工作者噁性腫瘤,主要是肺癌、食管癌、甲狀腺癌等噁性腫瘤的髮病危險增高,可能與其接受的慢性小劑量電離輻射職業照射有關.
목적 대아국의용X사선공작자수방대렬중최대적강소아조개전계속수방,분석1997-2011년대렬수방기간만성소제량전리복사조사유발악성종류적발병위험.방법 채용회고성대렬연구,유각시질병예방공제중심안조통일수방방안,경과통일배훈후,조직개전수방공작.채용Epicure지Datab계산수방대렬1997-2011년루계관찰인년분조렬표,이용AMFIT진행분조자료적Poisson회귀,계산조정성별、년령등인소후의용X사선공작자적각충악성종류적상대위험(RR)치급기95％CI.결과 공수방7 088인,기중,조사조3 668인,루계관찰94 651.2인년,실방솔위5.79％.재차기간진단신발악성종류441례.여대조조상비,조사조전부악성종류적RR위1.44(95％CI:1.18～1.75),실체암적RR위1.44(95％ CI:1.18 ～ 1.75).조사조발병솔명현상승적악성종류포괄폐암(RR=1.95,95％CI:1.30 ～2.92)、식관암(RR=3.04,95％CI:1.20 ～7.70)、림파암(RR =2.24,95％ CI:0.67 ～7.48)、백혈병(RR=1.57,95％CI:0.33 ～7.39)、후암(RR=2.47)화갑상선암(RR=2.80,95％ CI:0.24～ 32.26).대실방정황진행조정후,조사조실체암적RR=1.2(95％ CI:0.94 ～ 1.46).결론 1980년전삼가공작적강소성의용진단X사선공작자악성종류,주요시폐암、식관암、갑상선암등악성종류적발병위험증고,가능여기접수적만성소제량전리복사직업조사유관.
Objective To continue following up the cohort members in Jiangsu province who were the largest subgroup in Chinese medical X-ray workers cohort subgroups on radiation carcinogenesis and analysis the cancer risk of medical X-ray workers which might be induced by chronic low-dose ionizing radiation between 1997 and 2011.Methods A retrospective cohort study was utilized to accumulate data.Epicure was applied to compute cumulative person years (with module of Datab) and relative risk (including 95％ CI) of malignant tumor on exposed group(with module of AMFIT) while the factors such as sex and attained-age were adjusted in the cohort members.Results The 7 708 follow-up members included 3 668 medical X-ray workers.The cumulative person-year in the cohort members was 94 651.2 (1997-2011) and its lost rate was 5.79％.During the follow-up period,441 cases had became cancer patients.The relative risk of all cancers was 1.44 (95％ CI:1.18-1.75),so was the solid cancers.Significant elevated risks of cancer were found on lung (RR =1.95,95％ CI:1.30-2.92),esophagus (RR =3.04,95％ CI:1.20-7.70),lymphoma(RR =2.24,95％ CI:0.67-7.48),leukemia(RR =1.57,95 ％ CI:0.33-7.39),throat (RR =2.47) and thyroid (RR =2.80,95 ％ CI:0.24-32.26) among medical X-ray workers.However,The RR of malignant tumors might not be associated with occupational exposure to ionizing radiation if we considered the lost factors (RR =1.2,95％ CI:0.94-1.46)Conclusions The RR of malignant tumors such as the cancer on lung,esophagus,thyroid among the medical X-ray workers in Jiangsu province were enhanced which might be associated with occupational exposure to ionizing radiation.
