School of Public Health, FI-33014 University of Tampere, Finland.
Scand J Work Environ Health. 2011 May;37(3):237-43. doi: 10.5271/sjweh.3152. Epub 2011 Feb 17.
The aim of this study was to estimate the prevalence of lens opacities among physicians occupationally exposed to radiation - overall and by occupational factors - and to assess the feasibility of a large-scale study for risk assessment.
Based on a nationwide registry of 1312 physicians, mostly radiologists with occupational exposure to ionizing radiation, 120 subjects were invited to participate, of which 59 (49%) consented. The inclusion criteria included (i) age 45-70 years, (ii) cumulative recorded radiation dose >10 mSv, and (iii) duration of work with dose monitoring >15 years. The participants completed a questionnaire regarding occupational history and other risk factors for lens opacities. A full ophthalmological examination was performed. Lenticular changes were graded using the Lens Opacities Classification System, version II (LOCS II), and the Nidek EAS-1000 Scheimpflug slit-imaging videophotography system.
Lens opacities were detected in 42% [95% confidence interval (95% CI) 29-55] of the 57 physicians without prior cataract surgery. Nuclear opacities were found in 14% (95% CI 6-26), cortical in 7% (95% CI 2-19), and posterior subcapsular in 5% (95% CI 1-15) of the subjects. The prevalence of lens opacities increased with age, smoking, and cumulative recorded radiation dose. After controlling for age, gender, and smoking, the excess odds ratio for any lens opacity was 0.13 (95% CI -0.02-0.28) per 10 mSv of cumulative radiation dose.
Our preliminary results show cortical and posterior subcapsular lens opacities among physicians exposed to occupational radiation, consistent with recent studies on low dose radiation exposure. A full study with an unexposed reference group for risk estimation is warranted.
本研究旨在评估职业性放射暴露的医师中晶状体混浊的总体患病率和职业因素相关患病率，并评估进行大规模风险评估研究的可行性。
基于一个全国性的放射科医师登记数据库（该数据库包含 1312 名医师，他们大多职业性暴露于电离辐射），我们邀请了 120 名符合条件的医师参加研究，其中 59 名（49%）同意参加。纳入标准包括（i）年龄 45-70 岁，（ii）累积记录的辐射剂量＞10 mSv，以及（iii）有剂量监测的职业暴露工作经历＞15 年。参与者完成了一份关于职业史和其他晶状体混浊危险因素的调查问卷。对所有参与者进行了全面的眼科检查。使用 Lens Opacities Classification System，version II (LOCS II) 对晶状体混浊进行分级，并使用 Nidek EAS-1000 Scheimpflug slit-imaging 摄像摄影系统进行评估。
在 57 名未经白内障手术的医师中，有 42%（95%置信区间 95%CI 29-55）检测到晶状体混浊。核性混浊占 14%（95%CI 6-26），皮质性混浊占 7%（95%CI 2-19），后囊下混浊占 5%（95%CI 1-15）。晶状体混浊的患病率随年龄、吸烟和累积记录的辐射剂量而增加。在控制年龄、性别和吸烟因素后，每 10 mSv 累积辐射剂量的晶状体混浊的优势比为 0.13（95%CI -0.02-0.28）。
我们的初步结果显示，职业性放射暴露的医师中存在皮质性和后囊下晶状体混浊，与最近关于低剂量辐射暴露的研究结果一致。需要进行一项有未暴露对照组的全面研究来进行风险评估。
