职业辐射暴露与中国医疗放射工作人员甲状腺激素变化的队列研究。

Occupational Radiation Exposure and Changes in Thyroid Hormones in a Cohort of Chinese Medical Radiation Workers.

机构信息

School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, Guangdong, China;Guangdong Province Engineering & Technology Research Center for Medical 3D Printer and Personalized Medicine, Guangzhou 510006, Guangdong, China.

Department of Biomedical Engineering, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China;Guangdong Province Engineering & Technology Research Center for Medical 3D Printer and Personalized Medicine, Guangzhou 510006, Guangdong, China.

出版信息

Biomed Environ Sci. 2021 Apr 20;34(4):282-289. doi: 10.3967/bes2021.037.

DOI:10.3967/bes2021.037

PMID:33894807

Abstract

OBJECTIVE

This study aimed to evaluate the association between occupational radiation exposure and changes in thyroid hormone levels among medical radiation workers.

METHODS

This retrospective cohort study included 2,946 radiation workers from 20 Guangzhou hospitals. Data on general characteristics, participant radiation dosimetry, and thyroid function test results [thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroid hormone (T4)] were extracted from dosimetry and medical records. The generalized estimating equation was used to evaluate the trend of changes in thyroid hormone levels over time and was adjusted for age, gender, and occupation.

RESULTS

The average annual effective dose was very low and showed a general downward trend. During the follow-up period, changes in T3 and T4 levels among radiation workers were -0.015 [95% confidence interval ( ) -0.018 to -0.012] nmol/L per year and -2.294 (95% -2.426 to -2.162) nmol/L per year, respectively. Thyroid hormone levels were significantly different between males and females. T3 levels in the group of upper quartile of dose were significantly higher than in the lower quartile group ( = 0.006). No significant decreased trend in thyroid hormone levels was observed with increasing average effective doses.

CONCLUSION

Thyroid hormone secretion might be affected even in low-dose radiation exposure environments.

摘要

目的

本研究旨在评估职业辐射暴露与医疗放射工作人员甲状腺激素水平变化之间的关系。

方法

这是一项回顾性队列研究，纳入了来自广州 20 家医院的 2946 名放射工作人员。从辐射剂量学和病历中提取了一般特征、参与者辐射剂量学和甲状腺功能测试结果（促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）和甲状腺激素（T4））的数据。采用广义估计方程评估甲状腺激素水平随时间的变化趋势，并调整了年龄、性别和职业。

结果

平均年有效剂量非常低且呈总体下降趋势。在随访期间，放射工作人员 T3 和 T4 水平的变化分别为-0.015（95%置信区间（CI）：-0.018 至-0.012）nmol/L/年和-2.294（95%CI：-2.426 至-2.162）nmol/L/年。男女之间的甲状腺激素水平存在显著差异。剂量上四分位组的 T3 水平明显高于下四分位组（ = 0.006）。随着平均有效剂量的增加，甲状腺激素水平没有观察到明显的下降趋势。