Magnavita N, Fileni A
Istituto di Medicina del Lavoro, Università Cattolica del Sacro Cuore, Roma.
Radiol Med. 1994 Jul-Aug;88(1-2):107-11.
Ultrasound (US) is extensively used in the medical field for its therapeutic and diagnostic applications. US units are commonly found in hospitals and clinics of all sizes, and a growing number of medical staff such as doctors and nurses are exposed to hand-transmitted ultrasound waves in their work-place. This review discusses the available information on the occupational risk of the operators using diagnostic and therapeutic ultrasound devices. The new occupational groups of medical workers who use ultrasound (diagnostic, surgical, sterilization, and physiotherapeutic) equipment are exposed to contact ultrasound waves. Contact ultrasound -- i.e., no airspace between the energy source and the biological tissue -- is much more hazardous than exposure to airborne ultrasound because air transmits less than one percent of this kind of energy. In spite of being a non-ionizing radiation with an excellent safety record, US is likely to induce some changes in the exposed organ. Recent Russian studies indicate that the hospital workers who have been long exposed to ultrasound at work may develop neurovascular dose-dependent disorders of the peripheral nervous system in the form of the angiodystonic syndrome of vegetative polyneuritis of the hands. In some Scandinavian studies, female physiotherapists (exposed to ultrasound and short waves) exhibit increased rate of spontaneous abortions and congenital malformations, but no definite conclusion can be drawn on the basis of these results alone. Trends in exposure for diagnostic ultrasound equipment over the last two decades show a continuous increase. While there is no reason for alarm, there is a growing need for avoiding unnecessary exposure to medical workers.
超声(US)因其治疗和诊断应用而在医学领域得到广泛使用。各种规模的医院和诊所中普遍都有超声设备,越来越多的医务人员,如医生和护士,在工作场所会接触到手传播的超声波。本综述讨论了有关使用诊断和治疗超声设备的操作人员职业风险的现有信息。使用超声(诊断、手术、消毒和物理治疗)设备的新职业群体的医务人员会接触到接触式超声波。接触式超声——即能量源与生物组织之间没有空气间隙——比暴露于空气传播的超声危害大得多,因为空气只能传输不到1%的这种能量。尽管超声作为一种非电离辐射有着出色的安全记录,但它仍可能在受照射器官中引起一些变化。俄罗斯最近的研究表明,长期在工作中接触超声的医院工作人员可能会出现外周神经系统的神经血管剂量依赖性紊乱,表现为手部植物性多神经炎的血管张力障碍综合征。在一些斯堪的纳维亚的研究中,女性物理治疗师(接触超声和短波)的自然流产率和先天性畸形率有所增加,但仅根据这些结果无法得出明确结论。过去二十年中诊断超声设备的暴露趋势呈持续上升。虽然没有理由惊慌,但越来越有必要避免医务人员受到不必要的照射。