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Objective To analyze the micronucleus rate of radiation workers and to provide accurate occupational health monitoring basis in radiation workers exposed to low-level ionizing radiation for a long time. Methods The radiation group consisted of 353 radiation workers who had been exposed to ionizing radiation during work, while the control group consisted of 41 radiation workers who had not yet been exposed to ionizing radiation before work. The cytokinesis-block micronucleus method was used to determine the micronucleus rate. Results The average micronucleus rate in the radiation group was significantly higher than that in the control group (t = −2.95, P < 0.05). In the radiation group, the micronucleus rate gradually increased with age, and the difference was statistically significant (F = 8.36, P < 0.05). The micronucleus rates of workers with > 10 and > 30 years of service were significantly higher than those of workers with < 10 years of service (χ2 = −44.79, −60.47, P < 0.05). The micronucleus rate in females was significantly higher than that in males (t = 3.93, P < 0.05). The micronucleus rates in the diagnostic radiology group and the industrial detection group were significantly higher than that in the control group (t = 3.51, 3.65, P < 0.05). Conclusion The micronucleus rate has increased among the radiation workers exposed to low-level ionizing radiation for a long time. It is necessary to further strengthen occupational health monitoring and radiation protection education for radiation workers, especially the medical workers that constitute the largest population of radiation exposure workers.
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Objective To analyze micronucleus abnormalities in the peripheral blood lymphocytes of industrial radiation workers and the influencing factors, and to provide a reference for radiation protection. Methods The occupational health monitoring data of 661 industrial radiation workers were collected from the occupational health examination system of Gansu Provincial Center for Disease Control and Prevention. The abnormalities in the micronucleus of peripheral blood lymphocytes were analyzed. The influencing factors were identified by logistic regression. Results The micronucleus abnormality rate was 6.05% for the 661 industrial radiation workers. There was no significant difference in micronucleus abnormality rate between sexes (P > 0.05). Comparison of age groups showed that the rate of micronucleus abnormality increased with age, and workers over 50 years of age has the highest rate of micronucleus abnormalities (17.81%); there was a significant difference between age groups (P < 0.05). There was a significant difference in micronucleus abnormality rate between occupational categories (P < 0.05). There was a significant difference in micronucleus abnormality rate between groups with different years of work (P < 0.05). Logistic regression analysis showed that age and years of work were the risk factors for micronucleus abnormality rate (P < 0.05); age was an independent risk factor for micronucleus abnormality rate (P < 0.05). Conclusion The effect of low-dose ionizing radiation on micronucleus abnormality rate of industrial radiation workers is related to age and working years. Attention should be paid to occupational health monitoring of radiation workers, especially those with advanced age.
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Objective To investigate the current situation of occupational stress among radiation workers in nuclear power plants in China, to explore the factors influencing occupational stress, and to provide a reference for improving occupational stress. Methods A convenient sampling method was adopted to investigate the occupational stress of 100 radiation workers in two nuclear power plants in Fujian and Liaoning, using the general situation questionnaire, effort-reward imbalance questionnaire, and the radiation protection knowledge questionnaire. Independent samples t-test, one-way analysis of variance, chi-square test, and binary logistic regression analysis were used to examine the current situation of occupational stress and the influencing factors. Results The average value of effort-reward imbalance was 0.99 ± 0.15 and 47 (47%) radiation workers had occupational stress. There were significant differences in the detection rate of occupational stress among radiation workers with different ages, years of radiation work, monthly incomes, sleep durations (day), and exercise habits (P < 0.05). Logistic regression analysis showed that monthly income, sleep duration (day), and exercise habits were the influencing factors for occupational stress. Conclusion The occupational stress of radiation workers in nuclear power plants is a serious issue influenced by many factors. Attention should be given to this issue, and targeted interventions should be implemented to improve the social and working environment of this occupational group and reduce the level of occupational stress.
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Since the implementation of the Measures for the Management of Radiation Workers’ Occupational Health in November 2007, it has played an extremely important role in protecting the occupational health of radiation workers. There are more than 700 000 radiation workers in about 100 000 workplaces with potential radiation exposure, as well as a large number of miners exposed to high levels of radon. As the radiation health monitoring project suggests, measures of occupational health management such as personal dose monitoring and occupational health examination of radiation workers have been widely implemented and achieved good results in the protection of radiation workers. However, the risks of chromosomal aberration and specific turbidity of the eye lens of radiation workers have increased in high-risk positions such as interventional radiology, nuclear medicine, and industrial flaw detection. The control of high radon exposure in miners needs to be strengthened. It is necessary to adapt to the new situation in view of new challenges and actively promote the revision of the Measures for the Management of Radiation Workers’ Occupational Health, so as to further improve the occupational health management of radiation workers in China.
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In recent years, occupational stress has become a focus of public attention in public health in China and abroad. Radiation workers are exposed to ionizing radiation in their daily work, which further exacerbates their levels of occupational stress. This not only affects their physical and mental health, but also increases the potential for radiation incidents or accidents. Based on the literature on occupational stress among radiation workers in China throughout the years, this article provides a summary, conclusion, and systematical analysis of the research status of occupational stress among radiation workers, with a detailed sorting of the data. It explores key research issues and directions and provides reference for future work.
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Objective To investigate the operation status and service level of radiation occupational health inspection institutions in Zhejiang Province, China, and to provide a basis for administrative departments and quality management departments to develop policies. Methods The investigation data of radiation occupational health inspection institutions in Zhejiang Province were collected for descriptive analysis of the regional distribution, nature, and service qualification of the institutions. Results There were 27 radiation occupational health inspection institutions in Zhejiang Province. These institutions were located in 11 cities, of which 85.18% were public institutions and 14.72% were private institutions. For the physical examination workload of radiation workers in Zhejiang Province in 2021, general hospitals accounted for 75.90%, private institutions accounted for 4.51%, and occupational prevention and treatment hospitals accounted for 19.59%. In the radiation occupational health inspection institutions, the stand-alone and online software installation rates were 33.33% and 37.04%, respectively. A total of 26 986 individuals (82.97%) underwent chromosome aberration examination. The examination rates of thyroid color Doppler ultrasound examination and eye lens examination were 41.24% and 82.97%, respectively. Pre-job, on-job, and off-job physical examination accounted for 25.81%, 70.52%, and 3.67%, respectively. For radiation workers who underwent on-job physical examination, diagnostic radiology workers accounted for the highest proportion of 34.90%. The excellent, qualified, and unqualified rates of 27 radiation occupational health inspection institutions were 7.41%, 88.89%, and 3.70%, respectively. Conclusion The network of radiation occupational health inspection institutions in Zhejiang Province is well-established and located mainly in general hospitals, occupational prevention and control institutions, and private institutions. To enhance the quality and proficiency of occupational health examinations, it is imperative to prioritize self-improvement and management, reinforce law enforcement supervision, actively engage in blind sample assessments, and advance the application of information technology and standardized services.
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ObjectiveTo investigate the current status and high-risk factors of chromosomal aberrations in peripheral blood lymphocytes （PBL） of radiation workers in Hainan Province. MethodsA total of 200 radiological workers who underwent occupational health examination in Hainan Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were selected to collect the occupational health examination data and the rate of PBL chromosomal aberrations. The influencing factors of PBL chromosomal aberrations were analyzed by logistic regression model. The predictive value of logistic regression prediction model on PBL chromosomal aberrations were determined by using the reciver operator characteristic （ROC） curve. ResultsA total of 20 000 cells （100 cells/person） were tested. The chromosomal aberration rate was 0.37% （74/20 000） and the PBL chromosomal aberration rate in the subjects was 6.00% （12/200）. Univariate analysis showed that PBL chromosomal aberrations in radiological workers were related to age， length of service， type of work and education （all P<0.05）， but not to gender （P>0.05）. The logistic regression prediction model was constructed based on the influencing factors， with χ2=9.413， df=9， P=0.852， suggesting a good model fit. The logistic regression prediction model predicted the area under the curve （AUC） for the occurrence of PBL chromosomal aberrations in radiation workers was 0.914 （95%CI： 0.866‒0.949）， with a cut-off value of 3.05， corresponding to a prediction sensitivity and specificity of 100.00% and 75.98%， respectively. ConclusionThe incidence of PBL chromosomal aberrations in radiological workers in Hainan Province was 6.00%， with age， working age and job type as high-risk factors and education level as a protective factor. The prediction model constructed by the above factors can provide a reliable basis for clinical prediction of PBL chromosomal aberrations in radiological workers.
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Objective:To assess the effects of low-dose ionizing radiation on the thyroid of medical radiation workers.Methods:Based on the inclusion and exclusion criteria, 27 articles, involving 22 937 individuals, were screened finally from relevant literature published from 1996 to 2022. Meta-analysis was carried out using Stata 16.0 for serum levels of triiodothyronine (T 3), free triiodothyronine (FT 3), thyroid hormone (T 4), free thyroid hormone (FT 4), thyrotropin-stimulating hormone (TSH) and thyroid nodule rates. As well, subgroup analysis were carried out of thyroid function in different types of radiation workers. Results:The standardized mean difference (SMD) at T 3 and T 4 levels for radiation workers was -0.19 (-0.37, -0.01) and -0.34 (-0.38, -0.30), lower than that of control group ( Z=2.07, -16.06, P<0.05). The SMD at FT 4 levels for radiation workers was 0.22 (0.06, 0.39), higher than control group ( Z=2.61, P<0.05). The relative risk of thyroid nodules in radiation workers was 1.47 (1.19, 1.82), higher than that of control group ( Z=-3.58, P<0.05). The analysis result for subgroup showed that the SMD for T 3, T 4 and TSH levels in the interventional radiology workers were -0.29 (-0.51, -0.07), -0.31 (-0.47, -0.15) and -0.43 (-0.73, -0.13) ( Z=-2.55, -3.86, -2.82, P<0.05), respectively, and the SMD for T 4 levels in the nuclear medicine workers was -0.26 (-0.45, -0.07), which meaned a reduced risk compared to the control group ( Z=-2.70, P<0.05). Conclusions:Long-term low doses of ionising radiation may have adverse effects on thyroid hormone and thyroid nodule in radiation workers, particularly in interventional radiology workers, and attention should be focused on their radiation protection.
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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 2 839 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( χ2=416.06, 2 924.14, 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. Pre-employment 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.
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Objective@# To investigate the thyroid functions and influencing factors among radiation workers in Wuhan City, so as to provide insights into occupational health monitoring among radiation workers.@*Methods @#Radiation workers receiving physical examinations in Wuhan Prevention and Treatment Center for Occupational Diseases from January to October 2022 were enrolled, and participants' gender, age, smoking, alcohol consumption, medical history, medication use, types of occupational radiation and work duration were collected. Triiodothyronine (TT3), thyroxine (TT4), free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured using a magnetic microparticle-based chemiluminescence immunoassay. Personnel dose equivalent was monitored using thermoluminescent dosimetry, and annual cumulative radiation dose was estimated. Factors affecting thyroid function were identified using a multivariable linear regression model.@*Results@#Totally 978 radiation workers were recruited, with a median age of 32.00 (interquartile range, 10.00) years, and including 782 men (79.96%) and 196 women (20.04%). There were 246 smokers (25.15%), 257 workers with alcohol consumption (26.28%) and 489 with a history of radiation work (50.00%). The median annual cumulative radiation dose was 0.20 (interquartile range, 0.24) mSv. The percentage of abnormal thyroid function was 14.72%. Multivariable logistic regression analysis showed that women (OR=1.925, 95%CI: 1.061-3.490), history of radiation work (OR=2.810, 95%CI: 1.119-7.057) and involving in medical application (OR=1.915, 95%CI: 1.101-3.332) were associated with abnormal thyroid function.@*Conclusions@#The percentage of abnormal thyroid function was 14.72% among radiation workers in Wuhan City. History of exposure to ionizing radiation, types of occupational radiation and gender were main factors affecting thyroid function.
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Objective To analyze the micronucleus levels of peripheral blood lymphocytes of medical radiation workers, and to provide a basis for radiation protection to reduce occupational hazards caused by ionizing radiation. Methods A total of 1072 medical radiation workers were selected into radiation group, and 329 healthy adults who underwent pre-employment occupational physical examination and intended to be radiation workers were selected into control group. The micronucleated lymphocyte frequency was determined by whole blood micro-culture. Results There were no significant differences in micronucleated cell frequency and micronucleus frequency between the radiation group and the control group (both P > 0.05). The detection rate of micronucleus abnormalities in the radiation group was significantly higher than that in the control group (P < 0.001). Female radiation workers had significantly higher micronucleated cell frequency, micronucleus frequency, and the detection rate of micronucleus abnormalities than male radiation workers (all P < 0.001). Between different types of work, significant differences were observed in micronucleated cell frequency and micronucleus frequency (both P < 0.05), but not in the detection rate of micronucleus abnormalities (P > 0.05). Radiation workers with different lengths of working showed significant differences in micronucleated cell frequency (P < 0.05), micronucleus frequency (P < 0.05), and the detection rate of micronucleus abnormalities (P < 0.001). Significant differences were observed in micronucleated cell frequency and micronucleus frequency between different age groups (both P < 0.05). The Spearman’s rank correlation analysis showed that micronucleated cell frequency and micronucleus frequency were positively correlated with the age of radiation workers (both P < 0.001). Conclusion The micronucleus frequency of radiation workers was related to the type and length of work, and had a positive correlation with age. Radiation protection should be enhanced for workers engaged in medical radiation for a long period, especially female workers and workers with a long length of service.
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OBJECTIVE: To observe the effect of low dose long-term chronic irradiation on chromosome aberration and micronucleus in peripheral blood lymphocytes of interventional radiology workers.METHODS: A total of 100 interventional radiology workers in a grade A tertiary hospital of Henan Province were selected as the interventional group using a convenient sampling method, and 78 healthy individuals without radiation exposure were selected as the control group. The incidence of chromosomal aberration and micronucleus of peripheral blood lymphocytes in individuals of these two groups were investigated. RESULTS: The frequencies of cells with acentric fragment(ace), dicentric chromosome(dic), reciprocal translocation(t), chromosome type aberration and total aberration in the interventional group were higher than those in the control group, and the differences were statistically significant(0.55% vs 0.30%, 0.25% vs 0.03%, 0.38% vs 0.01%, 1.21% vs 0.34%, 1.37% vs 0.54%, all P<0.01). In the interventional group, the frequency of cell with chromosome type aberration was higher than that of chromatid type aberration(1.21% vs 0.16%, P<0.01).The frequency of cell with unstable chromosome aberration was higher than that of stable chromosome aberration(0.80% vs 0.41%, P<0.01), and the frequency of cell with chromosomal type aberrant in the interventional group ranked from high to low in order of ace, t, dic and deletion(P<0.01). The incidence of micronuclear cells and micronucleus in the interventional group were higher than those in the control group(0.86‰ vs 0.40‰, 0.89‰ vs 0.41‰, all P<0.01). The incidence of micronuclear cells and micronucleus of female interventional radiology workers were higher than those of male workers(1.12‰ vs 0.62‰, 1.19‰ vs 0.62‰, all P<0.01).CONCLUSION: Low dose and long-term chronic irradiation exposure can affect both chromosome aberration and micronucleus of interventional radiology workers. The main chromosomal aberrations were non-stable chromosomal aberrations ace, dic and stable chromosomal aberrations t.
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Objective@#To study the effects of sex, age, length of service, type of work and annual effective radiation dose on nucleoplasmic bridge (NPB) in the peripheral blood lymphocytes of radiation workers.@*Methods@#The peripheral blood samples of 100 radiation workers in Henan province were collected and the NPB in peripheral blood lymphocytes were measured by CBMN assay. The frequencies of NPB formation and NPB-containing cells were calculated, and the effects of various factors on NPB incidence were analyzed statistically.@*Results@#The NPB frequency in radiation workers was higher than that in healthy people (Z=-8.123, P<0.01). Except for sex, the factors of age, length of service, type of work and annual effective dose had significant influences on NPB (χ2= 7.202-45.571, P<0.05).@*Conclusions@#NPB reflects the effect of low-dose long-term chronic irradiation on the occupational radiation workers.
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Objective To study the effects of sex,age,length of service,type of work and annual effective radiation dose on nucleoplasmic bridge (NPB) in the peripheral blood lymphocytes of radiation workers.Methods The peripheral blood samples of 100 radiation workers in Henan province were collected and the NPB in peripheral blood lymphocytes were measured by CBMN assay.The frequencies of NPB formation and NPB-containing cells were calculated,and the effects of various factors on NPB incidence were analyzed statistically.Results The NPB frequency in radiation workers was higher than that in healthy people (Z=-8.123,P＜0.01).Except for sex,the factors of age,length of service,type of work and annual effective dose had significant influences on NPB (x2=7.202-45.571,P＜0.05).Conclusions NPB reflects the effect of low-dose long-term chronic irradiation on the occupational radiation workers.
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OBJECTIVE: To analyze the results of occupational health monitoring on radiation workers in national medical institutions in 2018. METHODS: Through the National Radiation Health Information Platform Subsystem Occupational Radiation Diseases and Occupational Health Monitoring System, the monitoring data including the overview of radiological diagnosis and treatment institutions, occupational health management, and occupational health examination information across the country were collected for analysis in 2018. RESULTS: In 2018, there were a total of 55 902 radiological diagnosis and treatment institutions with 353 141 radiation workers nationwide. The radiation dose monitoring rate on individuals and hospitals was 94.6%(334 222/353 141) and 97.3%(91 051/93 559), respectively. The rate of health examination was 84.6%(298 914/353 141) and 95.4%(87 031/91 244) respectively.The monitoring rate on chromosomal aberration in peripheral blood lymphocytes was 0.3% in radiation workers. The rate of opacity under the posterior lens capsule was 4.3% and the rate of thyroid nodules was 25.7% in interventional radiology and nuclear medicine workers. CONCLUSION:s The personal dose monitoring rate and occupational health examination rate of radiation workers in medical institutions in China are maintained at a relatively high level. However, monitoring attention should also be paid to the analysis of chromosome aberrations in peripheral blood lymphocytes, the examination of eye lens and thyroid gland.
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Objective@#To analyze the lens opacity of some hospitals in Hangzhou to provide evidence for further improvement of radiation protection.@*Methods@#Physical examination data of 1720 radiological workers who underwent occupational disease physical examination in our hospital on January1, 2016and December 31, 2017 were collected. Lens turbidity, gender, age, type of work, radiological working age and other influencing factors were statistically analyzed, and logistic regression analysis was used for multipactor analysis.@*Results@#A total of 112 cases of lens turbidity (turbidity rate 6.51%) , after lens turbidity, subcapsular majority (64 cases (57.14%) ) ; lens turbidity increased with age, and showed an increasing trend of radiation working age; the lens turbidity rate was different in different types of work, including nuclear medicine (23.33%) 、radiology (6.76%) 、interventional radiology (6.06%) 、dental radiology (4.26%) and radiotherapy (4.21%) . Type of work、age and length of service are risk factors for lens opacity; Age and type of work were independent risk factors for lens opacity.@*Conclusion@#The turbidity of lens of radiologcial workers is related to age and workering age. Radiological workers engaged in nuclear medicine should strictly strengthen radiation protection.
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Objective To analyze the changes in distribution of occupational radiation cases reported from 2013 to 2017 in China and learn about the occupational health risks of radiation workers.Methods Descriptive analyses were made of regional distribution,disease category distribution,occupation category distribution and exposure mode distribution of these cases,according to the reports (2013-2017) of occupational radiation sickness from " Occupational Health of Radiation Workers Management System".Results There were 54 diagnostic radiology agencies for occupational radiation sickness in China that covered all provinces,autonomous regions and municipalities except Tibet and Production and Construction Corps of Xinjiang.A total of 106 new cases were reported from 2013 to 2017.Most of the cases were radiogenic neoplasm (43.40％),and chronic radiation sickness were from external exposure (16.98％) and radiation cataract (16.04％).Most of the cases (70.75％) were engaged in medical application and a small part of the cases (13.21％) engaged in industry application.Chronic exposure (80.19％) was the most frequent form of exposure mode,but acute exposure (5.66％) was very few.A part of cases (14.15％) were reported without exposure mode.Conclusions The morbidity of occupational radiation sickness declined generally in China and occupational health management of key workers should be strengthened continuously.
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Objective@#To investigate occupational health status about radiation workers from township hospitals in Gansu, China, and to explore the dose-effect relationship of exposure dose of radiation workers.@*Methods@#A total of 390 X-ray workers from township hospitals in Gansu Province and 450 X-ray workers from the county/district-level hospitals in the county/district where the township hospitals were located were divided into research group and control group. Their workload, radiation protection condition, and occupational health monitoring data were used for impact assessment and risk estimation.@*Results@#The annual workload of radiation workers from township hospitals was 845.33±361.622 people, and that of radiation workers from county/district-level hospitals was 1967.74±762.055 people; there was a significant difference in annual workload between the two groups of subjects (P<0.05) . Indices such as detection rate of lens opacity, detection rate of abnormal platelet count, red blood cell count, and hemoglobin count, micronucleated lymphocyte rate, and chromosome aberration rate were significantly different between the two groups (P<0.05) .@*Conclusion@#Radiation workers from township hospitals suffer from certain radiation damage.
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OBJECTIVE: To investigate the individual external dose level of medical radiation staffs in Guangzhou City.METHODS: The medical radiation staffs of Guangzhou City who conducted individual dose monitoring at Guangdong Province Hospital Center for Occupational Diseases Prevention and Treatment from 2008 to 2014 were selected as study subjects by convenient sampling method.Their individual dosage monitoring data were analyzed.RESULTS: A total of 17 754 person-times were monitored in 7 years.The annual collective effective dose was 10 621.1 person·mSv and the median per capita annual effective dose was 0.21 mSv/a.The per capita annual effective dose in 2008-2012 showed an increasing trend each year( P < 0.05),peaked in 2012,and then decreased in 2013 and 2014( P < 0.05).The per capita annual effective dose of radiology staffs in level Ⅱ medical institutions was higher than that of level Ⅲ medical institutions,level Ⅰ medical institutions and those below level Ⅰ( P < 0.01).The per capita annual effective dose of radiation staffs in level Ⅲ medical institutions was higher than level Ⅰ medical institutions and those below level Ⅰ( P <0.01).The effective monitoring rates of radiation staffs monitored for 4 cycles every year increased with time from 2008 to 2014( P < 0.01).The effective monitoring rate increased with the hospital level( P < 0.01).The per capita annual effective dose of the staffs in radiological diagnosis department was lower than that of clinical nuclear medicine,radiotherapy and interventional radiology( P < 0.01).CONCLUSION: The radiation dose of medical radiation staffs in Guangzhou City was within the national standard limit.Protection should be focused on the the staffs in secondary hospitals,clinical nuclear medicine,radiotherapy and interventional radiology.
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OBJECTIVES: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.