Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France.
Occup Environ Med. 2018 Aug;75(8):533-561. doi: 10.1136/oemed-2017-104559. Epub 2018 May 2.
Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices.
From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade.
During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers.
Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.
从事核医学（NM）工作的技术人员所接受的辐射剂量比大多数其他职业暴露人群都要高。本研究旨在评估 NM 技术人员的癌症风险与工作经历、所进行的程序以及放射防护实践之间的关系。
在美国放射技师队列研究中，对 72755 名于 2003 年至 2005 年完成问卷调查的放射技师进行了随访，随访内容包括截至 2012 年 12 月 31 日的癌症死亡率以及通过 2012 年至 2013 年完成的问卷调查获取的癌症发病率。使用多变量调整模型，按曾进行 NM 程序的历史以及进行特定诊断或治疗性 NM 程序的频率以及每个十年与相关放射防护措施，估算总癌症发病率和死亡率的 HR。
在随访期间（平均 7.5 年），在从事 NM 程序的 22360 名技术人员中，有 960 例新发癌症和 425 例癌症死亡。我们未观察到曾进行 NM 程序的工作人员癌症发病率（HR 0.96，95%CI 0.89 至 1.04）或死亡率（HR 1.05，95%CI 0.93 至 1.19）增加的风险。对于 1960 年及以后开始进行治疗性程序的技术人员，癌症发病率的 HR 较高，但死亡率的 HR 没有变化。进行诊断或治疗性 NM 程序的频率以及放射防护措施的使用与癌症风险无一致相关性。未观察到特定癌症的明确相关性，但结果基于数量较少。
癌症发病率和死亡率与 NM 工作经历实践无关，包括进行的程序频率。
