工作场所中的辐射——职业性接触电离辐射风险研究综述

Radiation in the workplace-a review of studies of the risks of occupational exposure to ionising radiation.

作者信息

Wakeford Richard

机构信息

Dalton Nuclear Institute, The University of Manchester, Pariser Building-G Floor, PO Box 88, Sackville Street, Manchester M60 1QD, UK.

出版信息

J Radiol Prot. 2009 Jun;29(2A):A61-79. doi: 10.1088/0952-4746/29/2A/S05. Epub 2009 May 19.

Abstract

Many individuals are, or have been, exposed to ionising radiation in the course of their work and the epidemiological study of occupationally irradiated groups offers an important opportunity to complement the estimates of risks to health resulting from exposure to radiation that are obtained from other populations, such as the Japanese survivors of the atomic bombings of Hiroshima and Nagasaki in 1945. Moreover, workplace exposure to radiation usually involves irradiation conditions that are of direct relevance to the principal concern of radiological protection: protracted exposure to low level radiation. Further, some workers have been exposed to radioactive material that has been inadvertently taken into the body, and the study of these groups leads to risk estimates derived directly from the experience of those irradiated by these 'internal emitters', intakes of alpha-particle-emitters being of particular interest. Workforces that have been the subject of epidemiological study include medical staff, aircrews, radium dial luminisers, underground hard-rock miners, Chernobyl clean-up workers, nuclear weapons test participants and nuclear industry workers. The first solid epidemiological evidence of the stochastic effects of irradiation came from a study of occupational exposure to medical x-rays that was reported in 1944, which demonstrated a large excess risk of leukaemia among US radiologists; but the general lack of dose records for early medical staff who tended to experience the highest exposures hampers the derivation of risks per unit dose received by medical workers. The instrument dial luminisers who inadvertently ingested large amounts of radium-based paint and underground hard-rock miners who inhaled large quantities of radon and its decay products suffered markedly raised excess risks of, respectively, bone and lung cancers; the miner studies have provided standard risk estimates for radon-induced lung cancer. The large numbers of nuclear industry workers around the world present a possibility of deriving risk coefficients of direct relevance to radiological protection, and the recently published study of workers from 15 countries illustrates what can be achieved by international collaboration. However, it would appear that there are some problems with this study that require attention before reliance can be placed upon the results. Early workers from the Mayak plutonium production facility in Russia were heavily exposed to external sources of penetrating radiation and to plutonium, and appreciable effort has been expended in obtaining dependable risk estimates from this scientifically valuable group of workers. Those occupationally exposed to low levels of radiation also present an opportunity of studying possible somatic health effects other than cancer, such as heart disease and eye cataracts, that are the subject of much discussion at present. Overall, studies of exposure to ionising radiation in the workplace provide a valuable support to studies of those groups exposed under other circumstances, and in some instances (such as exposure to plutonium) effectively offer the only direct source of epidemiological evidence on risks.

摘要

许多人在工作过程中曾接触过电离辐射,对职业受照群体进行流行病学研究提供了一个重要机会,以补充从其他人群(如1945年广岛和长崎原子弹爆炸的日本幸存者)获得的辐射暴露对健康造成风险的估计。此外,工作场所的辐射暴露通常涉及与放射防护主要关注点直接相关的照射条件:长期暴露于低水平辐射。此外,一些工人曾接触过意外摄入体内的放射性物质,对这些群体的研究得出的风险估计直接来自于受这些“体内发射体”照射者的经验,摄入α粒子发射体尤其令人关注。接受过流行病学研究的人群包括医务人员、机组人员、镭表盘发光涂料涂敷工、地下硬岩矿工、切尔诺贝利清理工人、核武器试验参与者和核工业工人。关于辐射随机效应的首个确凿流行病学证据来自1944年报道的一项关于职业性医学X射线照射的研究,该研究表明美国放射科医生患白血病的风险大幅增加;但早期医务人员普遍缺乏剂量记录,而他们往往受到的照射剂量最高,这妨碍了得出医务人员每接受单位剂量辐射的风险。意外摄入大量镭基涂料的仪器表盘发光涂料涂敷工以及吸入大量氡及其衰变产物的地下硬岩矿工,分别患骨癌和肺癌的超额风险显著增加;矿工研究提供了氡致肺癌的标准风险估计。世界各地大量的核工业工人提供了得出与放射防护直接相关的风险系数的可能性,最近发表的一项对来自15个国家工人的研究说明了国际合作所能取得的成果。然而,这项研究似乎存在一些问题,在依赖其结果之前需要加以关注。俄罗斯马亚克钚生产设施的早期工人曾大量暴露于外部穿透辐射源和钚,为从这群具有科学价值的工人那里获得可靠的风险估计已付出了相当大的努力。那些职业性暴露于低水平辐射的人群也提供了研究除癌症之外可能的躯体健康影响(如心脏病和白内障)的机会,这些目前是大量讨论的主题。总体而言,对工作场所电离辐射暴露的研究为对其他情况下受照群体的研究提供了宝贵支持,在某些情况下(如钚暴露)有效地提供了关于风险的唯一直接流行病学证据来源。

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