Identifying clusters of health risk behaviors and their predictors in adult survivors of childhood cancer: A report from the French Childhood Cancer Survivor Study.

OBJECTIVE: Health risk behaviors (HRB) of childhood cancer survivors (CCS) are generally studied separately, despite the evidence suggesting that HRB are not independent. To our knowledge, few studies have examined HRB profiles in the former pediatric cancer patients. In this study, we identified HRB profiles and examined predictors engaging in unhealthy behaviors in CCS. METHODS: We used data from a French cohort of CCS that includes five-year survivors diagnosed between 1945 and 2000 and treated before reaching age 18, in five centers in France. A total of 2961 adult CCS answered a self-reported questionnaire pertaining to HRB. Latent class analysis was used to identify HRB profiles combining physical activity, smoking, cannabis use, and alcohol drinking. Multinomial logistic analyses examined predictors for engaging in unhealthy behaviors. RESULTS: Three HRB patterns emerged: "Low-risk" (n = 1846, 62.3%) included CCS who exhibited the highest frequency for usual physical activity and the lowest probabilities for current smoking or cannabis use, but most drank at least moderately; "Moderate-risk behaviors" (n = 291, 9.8%), and "High-risk behaviors" (n = 824, 27.8%) for CCS who exhibited the highest frequencies for current smoking, cannabis use, and heavy drinking. The multivariable regression revealed that male CCS, less educated or not married were significantly more likely to be in the high-risk behaviors group than the low-risk group. CONCLUSIONS: As CCS remain a vulnerable population, screening for HRB should be routinized in long-term follow-up care and interventions targeting multiple HRB simultaneously among survivors should be developed.

A systematic review of occupational radiation individual dose monitoring among healthcare workers exposed in Africa.

Dosimetric monitoring is useful to limit exposures to ionising radiation in medical occupational settings, and reduce subsequent health risks. Scientific literatures, such as the UNSCEAR report 2017 and International Atomic Energy Agency Report 2014b, updated information on this subject; however, few African works have been found. This is the reason why we undertook this study, which summarises existing information on monitoring external radiation exposure doses for the whole body, using data from medical workers on this continent. Using standard terms and combining different keyword searches for radiation dose monitoring among radiology healthcare workers in Africa, from the titles, abstracts, and full texts, we found 3139 articles in the PubMed/MEDLINE, Google Scholar and INIS databases. Two reviewers screened the retrieved publications based on predefined eligibility criteria to identify relevant studies, extract key information from each, and summarise the data in table form. A total of 20 potentially relevant articles were identified. Among these 20 articles, 15 reported the overall average annual effective dose. Studies included in this systematic review represent an inventory of the radiation protection of medical workers in various African countries, with a focus on the monitoring of occupational radiation exposure. The size of studied populations ranged between 81 and 5152 occupational exposed workers. The mean annual effective doses ranged from 0.44 to 8.20 mSv in all specialities of medical sectors, while diagnostic radiology ranged from 0.07 to 4.37 mSv. For the nuclear medicine and radiotherapy from medical groups, the mean annual effective dose varied between 0.56 and 6.30 mSv. Industrial and research/teaching sectors data varied between 0.38 to 19.40 mSv. In conclusion, more studies implemented on dosimetric monitoring in Africa are needed to get a real picture of occupational exposure in the continent.

Experimental Assessment of Workplace Radiation Exposure in Diagnostic X-ray Medical Imaging Centres in Benin from 2019 to 2020.

The ease of prescribing radiological examinations has prompted an expansion in radiological procedures and, consequently, an increase of occupational dose to medical imaging workers. However, little is known about radiation exposure in the workplace of medical radiology professionals in many countries, and in Benin particularly. The purpose of this study was to assess ambient radiation doses in diagnostic X-ray medical facilities in Benin and to observe whether exposure levels are below reference levels. A total of 72 public and private medical imaging centres participated in a cross-sectional study carried out from June 2019 to February 2020 in Benin. These centres had 59 X-ray, four chest and six computed tomography (CT) scan rooms. A calibrated radiameter able to measure short, pulsed or continuous X fields and gamma/beta (50 nSv to 10 Sv) was used to measure exposure levels in these functional rooms. Scattered X-ray doses and exposure time from radiological examinations both behind the lead glass of the control area to assess the levels of exposure of professionals and outside of the examination room to evaluate the level of exposure of the public (including non-exposed workers) have been provided. Equivalent doses estimated per hour were compared with the reference levels of 7.50 and 0.05 µSv per hour for workers and the public, respectively. At the control area, the mean/median (min-max) equivalent doses were 0.09/0.07 (0.00-0.21), 2.39/0.13 (0.00-75.67), and 228.39/28.65 (0.39-869.75) µSv per hour for the chest, X-ray, and CT-scan rooms, respectively. Among 69 examination rooms, 13.04% of the equivalent dose estimated in the workplace behind the lead glass was greater than 7.50 µSv per hour; 65 out of 69 examination rooms showed that 40.00% of the equivalent dose estimated behind the doors was greater than 0.05 µSv per hour. These results demonstrated that current controls, including leaded glass separating the control panel and leaded doors between the examination room and the corridor, are inadequate to limit radiation exposures. The controls must be upgraded and a dosimetry program should be implemented to monitor exposures of employees, patients, and visitors.