Cardarelli J, Spitz H, Rice C, Buncher R, Elson H, Succop P
National Institute for Occupational Safety & Health, Robert A Taft Laboratories (R-44), Health-Related Energy Research Branch, 4676 Columbia Parkway, Cincinnati, Ohio 45226, USA.
Am J Ind Med. 2002 Dec;42(6):490-501. doi: 10.1002/ajim.10137.
Previous epidemiologic studies of workers at nuclear weapons facilities have not included X-ray exposures as part of the occupational radiation exposure. The research objective was to determine the contribution of work-related chest X-ray (WRX) exposure relative to the cumulative occupational radiation exposure.
Cases and controls were identified from a cohort of workers whose employment began as early as 1943. Medical records for 297 subjects were used to determine the bone marrow dose from their X-ray examinations. Individual dose data, however, were only available for 45 workers. Bone marrow dose estimates were calculated by converting the entrance-skin-exposure (from X-ray procedures) and occupational exposure (from monitoring data) to dose.
Stereoscopic photofluorography delivered a bone marrow dose nearly 100 times that delivered by today's chest X-ray technique. Photofluorography was the predominant radiation source during the 1940s and 1950s. The cumulative WRX dose was, on average, 50 times their occupational doses. No correlation between occupational and WRX dose was found, but may be due to the small study size and incomplete dose data.
These findings illustrate the importance of including WRX doses in retrospective epidemiological studies of radiation workers, especially if photofluorographic chest X-rays were performed and occupational exposure to ionizing radiation is low.
以往对核武器设施工作人员的流行病学研究未将X射线照射纳入职业辐射暴露范围。研究目的是确定与职业累积辐射暴露相关的工作相关胸部X射线（WRX）照射的贡献。
从最早于1943年开始工作的一组工人中确定病例和对照。使用297名受试者的医疗记录来确定其X射线检查的骨髓剂量。然而，仅获得了45名工人的个人剂量数据。通过将（来自X射线检查的）皮肤入口照射量和（来自监测数据的）职业照射量转换为剂量来计算骨髓剂量估计值。
立体荧光摄影术产生的骨髓剂量几乎是当今胸部X射线技术的100倍。荧光摄影术是20世纪40年代和50年代的主要辐射源。WRX累积剂量平均是其职业剂量的50倍。未发现职业剂量与WRX剂量之间存在相关性，但这可能是由于研究规模小和剂量数据不完整所致。
这些发现说明了在辐射工作人员的回顾性流行病学研究中纳入WRX剂量的重要性，特别是如果进行了荧光摄影胸部X射线检查且职业性电离辐射暴露较低的情况下。
