Investigation On Radiation Protection And Occupational Health Status Of Medical Radiation Workers In Xinjiang

Objective:With the wide application of ionizing radiation in the medical field,the number of radiological diagnosis and treatment equipment is increasing gradually.Attention should be paid to the occupational exposure risk and radiation protection status of medical radiological workers.By analyzing the results of radiological diagnosis and treatment equipment and workplace protection testing in medical institutions in Xinjiang,as well as the individual dose level and occupational health examination results of radiation workers in Xinjiang,this study aims to understand the changing trend of individual dose level of medical radiation workers in Xinjiang in recent years,and explore the occupational health damage of low-dose ionizing radiation workers.To provide reference for optimizing radiation protection management measures and evaluating occupational health status of radiation workers.Methods:The individual dose monitoring results of 7515 medical radiological workers from 2018 to 2021 were retrospectively analyzed,and 82 medical institutions were selected for on-site radiological protection detection and part of the radiological workers were surveyed by questionnaire.The status investigation design was adopted,and 1250 on-duty radiation workers were selected as the radiation group by stratified cluster,and the pre-on-duty workers who were not exposed to radiation during the same period were selected as the control group.The results of occupational health examination between the radiation group and the control group were compared and analyzed.Meanwhile,the levels of various detection indicators and abnormal conditions of the occupational health examination results of medical radiation workers with different characteristics during the on-duty were analyzed.t test,analysis of variance,Mann-Whitney U rank sum test and Kruskal-Wallis H rank sum test were used for measurement data,and chi-square test was used for counting data.Multivariate Logistic regression was used to analyze the effects of ionizing radiation exposure on the abnormalities of various items in occupational health examination.Results:1.From 2018 to 2021,the annual effective dose per capita for medical radiation workers decreased first and then increased,with an average level of 0.25 m Sv/a.The highest annual effective dose per capita was 0.35 m Sv in 2018.The lowest was 0.17 m Sv in 2020.The annual effective dose of 97.96% of radiological workers was lower than 1m Sv,and no annual effective dose was found to exceed the limit set by the national standard.The average annual effective dose of nuclear medicine workers was higher than that of other occupational categories(P < 0.05).The average annual effective dose of radiological staff in tertiary hospitals was higher than that in other grade hospitals(P < 0.05).2.A total of 223 radiological diagnosis and treatment equipment were tested in medical institutions,with a qualified rate of 85.7%.A total of 2,753 test indexes of radiological diagnosis and treatment equipment were set,and the passing rate was 98.4%.The qualified rates of radiological diagnosis and treatment equipment and test indexes in Grade I and below hospitals were lower than those in other grade hospitals(all P < 0.05).A total of 209 machine rooms were tested,and the pass rate was 96.7%.A total of6514 testing points were set up in the machine room,and the pass rate was 99.9%.Compared with different levels of medical institutions,there was no statistical significance in the qualified rate of equipment room and test points(P > 0.05).3.The radiation protection status of medical radiation workers is generally good,among which the best implementation of radiation protection is occupational health examination,and the radiation management status of participating units is relatively weak.There were statistically significant differences in radiation protection among radiological workers with different characteristics(all P < 0.05).4.The abnormal rates of blood routine,thyroid function,cardiovascular system and chest radiograph in radiation group were higher than those in control group(all P < 0.05).After adjusting for gender and age,the risk of abnormal blood routine in the radiation group was 1.283 times that of the control group(OR=1.283,95%CI: 1.049-1.568,P=0.015),and the risk of abnormal cardiovascular system in the radiation group was 1.846 times that of the control group(OR=1.846,95%CI: 1.497～2.276,P < 0.001).Compared with the occupational health examination results of medical radiological workers with different characteristics,the abnormal rates of hemoglobin,white blood cells,platelets,thyroxin,thyrotropin,liver and kidney function,cardiovascular system and chest radiograph were statistically significant between different genders(all P < 0.05).The abnormal rates of platelet,uric acid,cardiovascular system and chest radiographs were statistically significant among different ages(all P < 0.05).There were significant differences in the abnormal rates of triiodothyronine,creatinine,cardiovascular system and chest radiograph among different working years(all P < 0.05).The abnormal rate of erythrocyte was significantly different among different jobs(P < 0.05).Conclusion:1.In recent years,the per capita annual effective dose of medical radiation workers in Xinjiang has been kept at a low level,and no individual dose has been found to exceed the limit set by national standards.The per capita effective dose of radiological staff in nuclear medicine and tertiary hospitals is relatively high,which requires intensive monitoring in later stage.The results of radiological diagnosis and treatment equipment and workplace testing in medical institutions mostly met the national standards,and the unqualified workplaces were mainly concentrated in first-class and lower hospitals.The primary and lower hospitals and workplaces should be regarded as the focus of radiological health protection,and more funds should be invested to regularly supervise and urge the completion of radiological health protection testing.2.Exposure to low doses of ionizing radiation may increase the risk of abnormal blood routine and cardiovascular system in radiation workers.The occupational health status of medical radiation workers in Xinjiang is generally good,and the test results are basically within the normal range.The abnormal rate and detection level of each index of occupational health examination are closely related to sex,age,length of service and type of work.We should focus on strengthening health monitoring of blood routine,thyroid function,renal function and cardiovascular system,so as to timely detect health problems and ensure our own safety.