Daniels Robert D, Kubale Travis L, Spitz Henry B
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Am J Ind Med. 2005 Mar;47(3):206-16. doi: 10.1002/ajim.20141.
Previous analyses suggest that worker radiation dose may be significantly increased by routine occupational X-ray examinations. Medical exposures are investigated for 570 civilian workers employed at the Portsmouth Naval Shipyard (PNS) at Kittery, Maine. The research objective was to determine the radiation exposure contribution of work-related chest X-rays (WRX) relative to conventional workplace radiation sources.
Methods were developed to estimate absorbed doses to the active (hematopoietic) bone marrow from X-ray examinations and workplace exposures using data extracted from worker dosimetry records (8,468) and health records (2,453). Dose distributions were examined for radiation and non-radiation workers.
Photofluorographic chest examinations resulted in 82% of the dose from medical sources. Radiation workers received 26% of their collective dose from WRX and received 66% more WRX exposure than non-radiation workers.
WRX can result in a significant fraction of the total dose, especially for radiation workers who were more likely to be subjected to routine medical monitoring. Omission of WRX from the total dose is a likely source of bias that can lead to dose category misclassification and may skew the epidemiologic dose-response assessment for cancers induced by the workplace.
先前的分析表明，常规职业性X射线检查可能会显著增加工人的辐射剂量。对缅因州基特里朴茨茅斯海军造船厂（PNS）的570名文职工人的医疗照射情况进行了调查。研究目的是确定与工作相关的胸部X射线（WRX）相对于传统工作场所辐射源的辐射暴露贡献。
利用从工人剂量测定记录（8468份）和健康记录（2453份）中提取的数据，开发了估算X射线检查和工作场所暴露对活跃（造血）骨髓吸收剂量的方法。对辐射工人和非辐射工人的剂量分布进行了检查。
荧光摄影胸部检查产生的剂量占医疗源剂量的82%。辐射工人从WRX获得的集体剂量占其总剂量的26%，且比非辐射工人多接受66%的WRX照射。
WRX可导致总剂量的很大一部分，尤其是对于更有可能接受常规医疗监测的辐射工人。总剂量中遗漏WRX可能是偏差的一个来源，可能导致剂量类别错误分类，并可能扭曲工作场所诱发癌症的流行病学剂量反应评估。
