Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong, China.
Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, 4006, Australia.
Environ Health Prev Med. 2021 Jan 25;26(1):14. doi: 10.1186/s12199-021-00939-z.
Numerous studies have concentrated on high-dose radiation exposed accidentally or through therapy, and few involve low-dose occupational exposure, to investigate the correlation between low-dose ionizing radiation and changing hematological parameters among medical workers.
Using a prospective cohort study design, we collected health examination reports and personal dose monitoring data from medical workers and used Poisson regression and restricted cubic spline models to assess the correlation between changing hematological parameters and cumulative radiation dose and determine the dose-response relationship.
We observed that changing platelet of 1265 medical workers followed up was statistically different among the cumulative dose groups (P = 0.010). Although the linear trend tested was not statistically significant (P = 0.258), the non-linear trend tested was statistically significant (P = 0.007). Overall, there was a correlation between changing platelets and cumulative radiation dose (a change of β 0.008 × 10/L during biennially after adjusting for gender, age at baseline, service at baseline, occupation, medical level, and smoking habits; 95% confidence interval [CI] = 0.003,0.014 × 10/L). Moreover, we also found positive first and then negative dose-response relationships between cumulative radiation dose and changing platelets by restricted cubic spline models, while there were negative patterns of the baseline service not less than 10 years (- 0.015 × 10/L, 95% CI = - 0.024, - 0.007 × 10/L) and radiation nurses(- 0.033 × 10/L, 95% CI = - 0.049, - 0.016 × 10/L).
We concluded that although the exposure dose was below the limit, medical workers exposed to low-dose ionizing radiation for a short period of time might have increased first and then decreased platelets, and there was a dose-response relationship between the cumulative radiation dose and platelets changing.
大量研究集中在意外或治疗性大剂量辐射暴露上,而很少涉及低剂量职业暴露,以调查低剂量电离辐射与医务人员血液学参数变化之间的关系。
采用前瞻性队列研究设计,收集医务人员健康检查报告和个人剂量监测数据,采用泊松回归和限制立方样条模型评估血液学参数变化与累积辐射剂量之间的相关性,并确定剂量-反应关系。
我们观察到,1265 名随访医务人员的血小板变化在累积剂量组之间存在统计学差异(P = 0.010)。虽然线性趋势检验无统计学意义(P = 0.258),但非线性趋势检验有统计学意义(P = 0.007)。总体而言,血小板变化与累积辐射剂量之间存在相关性(调整性别、基线年龄、基线服务年限、职业、医疗水平和吸烟习惯后,每两年变化β 0.008×10/L;95%置信区间[CI] = 0.003,0.014×10/L)。此外,我们还通过限制立方样条模型发现,累积辐射剂量与血小板变化之间存在先正后负的剂量-反应关系,而基线服务年限不少于 10 年(-0.015×10/L,95%CI =-0.024,-0.007×10/L)和放射科护士(-0.033×10/L,95%CI =-0.049,-0.016×10/L)的模式呈负相关。
我们的结论是,虽然暴露剂量低于限值,但短时间内接触低剂量电离辐射的医务人员血小板可能先增加后减少,并且血小板变化与累积辐射剂量之间存在剂量-反应关系。