| ObjectiveIt will be studied that the occupational health status of radiation workers in Shandong province through analyzing the health examination data of radiation workers in order to provide reliable scientific basis for future making health policy and improving supervision work.Methods1.In this study,the workers engaged in radiation-associated job in Shandong province was considered as the research objects,physical examination results from a total of 3104 subjects were collected and registered in the integrated management system in medical science research institute of Shandong province.The radiation workers were from the total number is 372 units,there are 323 medical units and 12 institutions distributed in 12 cities,and 49 enterprises distributed in the province 6 cities.2.The radiation workers were grouping as following groups:gender(male and female),age(?20,21-30,31-40,41-50,51-60 and ?61 years),working age(?10,11-20,21-30 and ?31 years),type of work(diagnostic radiology 2A,nuclear medicine 2C,radiation therapy 2D,interventional radiology 2E,industrial flaw detection 3B),and the unit level(grade 3-hospitals,grade 2-hospital,grade 1-hospital,institutions(such as CDC)and enterprise units(such as industrial and mining enterprises used irradiation).And then the physical examination results were statistically analized based on above groups.3.According to "Law on the Prevention and Control of Occupational Diseases in the People's Republic Of China","Regulations on Safety and Protection of Radioactive Isotope and Ray Devices","Regulations on the Management of Radiation Diagnosis and Treatment" and "The Measures for Occupational Health Management of Radiation Workers",the survey included asking general items(such as family history,occupational history,clinical symptoms,etc)and physical examination of radiation workers(internal medicine routine,dermatology,ophthalmology and other examinations).Whole blood cells were measured by automatic blood count analyzer.The rate of chromosome aberration and micronucleus was carried out by the lymphocytes according to the standard methods.4.Statistical methods:Statistical Analysis of Factors Affecting the Health Status of Radiation Workers by SPSS22.0 Software.The abnormal rate was used to describe the status of health index,and the binary Logistic regression was used to analyze single factor and multiple factors.All statistical tests were carried out by bilateral test(a=O.05),P?0.05,the difference was statistically significant.Results1.The analysis of function of cardiovascular systemThe abnormal rate of blood pressure of radiation workers was significantly different in all groups(P<0.05).The abnormal rate of heart rate in radiation workers in the groups of different age,working age and different unit level was significantly different(P<0.05).There was significant difference of abnormal rate of ECG in the radiation workers in the groups of different age,length of service and type of work(P<0.05).By logistic regression analysis for above data,it is indicated that the abnormal rate of male was higher than female workers(P<0.001,OR=0.452)and the abnormal rate of older age group of radiation workers was higher than that of lower age,suggesting that gender and age are independent impact factors of abnormal blood pressure;Different unit level was the independent influence factor of abnormal heart rate;gender,age,length of service type of work and unit level were not the influencing factors of abnormal ECG.2.The analysis of the tests of peripheral bloodThere was significant difference in the abnormal rate of WBC count among workers in the groups of the gender,length of service and unit level(P<0.05).There were significant differences of the abnormal rate of HGB of radiation workers in the groups of the gender,type of work and unit level(P<0.05).The abnormal rate of PLT in radiation workers was different in the gender,type of work and unit level(P<0.05).The results of logistic regression analysis indicated that gender was independent impact factor in abnormal WBC of radiation workers;gender and unit level are independent impact factors to HGB abnormalities in radiation workers;gender and unit level are independent impact factors PLT abnormality in radiation workers.3.The results of chromosome aberration and micronucleusThere were significant differences of chromosome aberration and micronucleus in radiation workers in the gender,age,length of service,type of work and unit level(P<0.05).Following the increase of age and working age,the rate of chromosome aberration and micronucleus was higher gradually,which there were significant differences among the groups(P<0.05).The micronucleus rate of radiation worker in industrial inspection personnel working in industrial and mining enterprises was significantly higher than that of other units and types of work(P<0.05);The frequency of micronucleus in male radiation workers was significantly higher than that of female(P<0.05).By logistic regression analysis,it was found that age and unit level were independent influencing factors of chromosome aberrations and abnormal rate of micronucleus of radiation workers;it was found that age was independent influencing factors of abnormal rate of micronucleus of radiation workers.4.The results of the function of liver and renal4.1 Results of the indexes of liver functionExcept for work type and unit levels,there were differences of the ALT abnormal rate of radiation workers among other groups(P<0.05).The abnormal rate of TP of radiation workers was not significantly different in the gender,age,length of service,work type and unit level(P>0.05).The abnormal rate of A/G was different among other groups except age and length of service(P<0.05).The abnormal rate of GLB in radiation workers only in unit level was significantly different.By logistic regression analysis,it showed that the gender and length of service were independent factors of ALT abnormality in radiation workers.Gender,age,length of service,type of work and unit level were not the impact factors of TP abnormality;Age and gender were the independent impact factors of A/G abnormality;Unit level is the independent influence factor of GLB anomaly.4.2 Results of the indexes of renal functionThe abnormal rate of UA in radiation workers was significantly different between gender and age(P<0.05).Except for the type of work and unit level,the abnormal rate of Cr in radiation workers was different in other groups(P<0.05).There was significant difference of the abnormal rate of BUN in the gender(P<0.05).By logistic regression analysis,the gender was the independent influence factor of UA abnormality only;age and sex were independent impact factors of Cr abnormality;gender,age,seniority,type of work and unit level were not the impact factors of BUN abnormality.5.Results of blood lipid and blood glucose5.1.The results of blood lipidThe TC abnormal rate of radiation workers was significantly different in the groups of age and length of service(P<0.05).The abnormal rate of TG in the radiation workers was significantly different in the other groups except for the length of service and the unit level(P<0.05).There was significant difference in the abnormal rate of HDL for the sex difference(P<0.05).The abnormal rate of LDL was significantly different in the other groups except the working age(P<0.05).By logistic regression analysis,the age was an independent impact factor of TC and TG abnormalities.The gender was the independent influence factor of HDL abnormality,the gender and unit level were independent impact factors of LDL abnormality.5.2.The results of blood glucoseThe abnormal rate of blood GLU of radiation workers were significantly different by the age and service age(P<0.05).The abnormal rate of blood GLU was higher with the increase of working age.By logistic regression analysis,the gender,age,length of service,type of work and unit level were not the impact factors of GLU abnormality.6.The results of eye lens analysisIt was showed that the abnormal rate of eye lens was higher with the increase of age and working age;the abnormal rate of eye lens in the radiation workers engaged in the work type of 2C was significantly higher than that of other workers(P<0.05);The abnormal rate of eye lens in the workers of industrial and mining enterprises was significantly higher than that in other units(P<0.05);The abnormal rate of eye lens of male radiation workes was significantly higher than that of female(P<0.05).There were significant differences in the abnormal rate of eye lens in the groups of radiation workers(P<0.05).The results of logistic regression analysis showed that the abnormal rate of eye lens in older and higher seniority was higher than that in younger and lower length groups.7.Other clinical indicators examined resultsBy B ultrasound examination,the main abnormalities of the radiation workers found include fatty liver,gallstones and polyps,hepatic cyst,hepatic hemangioma,etc;Urine ketone body,occult blood,protein,urine sugar were found in urine routine examination;Thyroid nodules,T3,T4 and TSH abnormalities were found in the thyroid function examination;5 patients with positive skin tests(one with psoriasis,one with nerve,and one with a nail dystrophy,two cases of nail longitudinal crest)in all objects were found in this study.ConclusionThe current status of the health of radiation workers in Shandong province:the long-term low-dose radiation exposure can affect health indicators in radiation workers,which was covered cardiovascular system,peripheral blood index,liver and kidney function,blood lipid,blood glucose and eye lens.And the rate of chromosome aberration and micronucleus was also enhanced at certain level.The change of above indexes may associate with gender,age,service age,work type and unit levels. |
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