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一名放射肿瘤学家患急性淋巴细胞白血病病例的工作相关性。

The work-relatedness at a case of acute lymphoblastic leukemia in a radiation oncologist.

作者信息

Kim Bong Hyun, Kwon Young-Jun, Ju Young-Su, Kim Bong Kyu, Lee Hyun Seok, Lee Sang-Gil, Chung Yun Kyung

机构信息

Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea.

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan city, Republic of Korea.

出版信息

Ann Occup Environ Med. 2017 Jun 27;29:28. doi: 10.1186/s40557-017-0186-8. eCollection 2017.

Abstract

BACKGROUND

Clinicians who perform radiation therapy (RT) are exposed to radiation, which may negatively affect their health. The present study reports a case of acute lymphoblastic leukemia in a healthcare provider who was exposed to radiation at work; we also present a literature review of this topic.

CASE PRESENTATION

A 45-year-old patient, who had been a radiation oncologist and had been exposed to radiation while performing brachytherapy 10 years ago, complained of chest pain and was suspected of having leukemia based on the results of a blood test in an outpatient clinic. He was diagnosed with acute lymphoblastic leukemia, and subsequently underwent chemotherapy. However, the case died during treatment. Through epidemiological investigation, it was found that the case's cumulative exposure dose based on personal exposure and spatial dose measured during the work period was in the range of 6.08-12.15 mSv.

CONCLUSIONS

Based on the following considerations, acute lymphoblastic leukemia was highly correlated with the level of radiation to which the case was exposed while performing brachytherapy on patients with cancer. Firstly, the latent period of acute lymphoblastic leukemia in the case closely matched the latency time reported in previous published studies (5-10 years). In addition, numerous studies have reported significantly higher relative risks of cancer among clinicians who perform RT compared with the general population. The case was also atypically exposed to radiation through his hands, despite wearing protective equipment. Lastly, the case's coworkers were also found to have been exposed to high levels of radiation. Investigation into the influence of radiation exposure through atypical routes during RT on the health of clinicians is recommended.

摘要

背景

从事放射治疗(RT)的临床医生会接触辐射,这可能会对他们的健康产生负面影响。本研究报告了一名在工作中接触辐射的医护人员患急性淋巴细胞白血病的病例;我们还对该主题进行了文献综述。

病例介绍

一名45岁的患者,曾是一名放射肿瘤学家,10年前在进行近距离放射治疗时接触过辐射,因胸痛在门诊就诊,根据血液检查结果怀疑患有白血病。他被诊断为急性淋巴细胞白血病,随后接受了化疗。然而,该病例在治疗期间死亡。通过流行病学调查发现,根据工作期间测量的个人暴露和空间剂量,该病例的累积暴露剂量在6.08 - 12.15毫希沃特范围内。

结论

基于以下考虑,急性淋巴细胞白血病与该病例在对癌症患者进行近距离放射治疗时所接触的辐射水平高度相关。首先,该病例中急性淋巴细胞白血病的潜伏期与先前发表的研究报告的潜伏期时间(5 - 10年)密切匹配。此外,许多研究报告称,与普通人群相比,从事放射治疗的临床医生患癌症的相对风险显著更高。尽管佩戴了防护设备,但该病例仍通过手部非典型地接触到了辐射。最后,还发现该病例的同事也接触到了高水平的辐射。建议调查放射治疗期间通过非典型途径接触辐射对临床医生健康的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/5485618/251f9f10f13f/40557_2017_186_Fig1_HTML.jpg

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