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Objective:To investigate and analyze the eye lens dose to interventional radiology workers in China from 2019 to 2021.Methods:The monitoring data on eye lens dose to interventional radiology workers from 31 province-level units during 2019-2021 were collected through the National Radiological Health Information Platform. The eye lens dose evaluation indicator was Hp(3), with each monitoring period of no more than 3 months. Kusall-Wallis H test was used for the comparison of multiple groups and pairwise. Results:A total of 6 643 interventional radiology workers were investigated from 2019 to 2021. The average annual eye lens dose was 1.03 mSv, with the median of 0.17 mSv and the maximum of 94.88 mSv. The annual eye lens dose to 59 workers exceeded 20 mSv. It was also found that the annual eye lens dose to the doctors in 2019 and 2020 was slightly higher than that to nurses (rank mean difference=118.29, 129.71, P<0.01), and the lens dose to interventional radiology workers who performed cardiac interventions in 2019 was higher than that to workers who performed peripheral vascular interventions (rank mean difference=46.52, P<0.05). Conclusions:The lens dose to interventional radiology workers is lower than the limits given in Chinese national standard currently in effect, but exceed the latest internationally recommended limit for a few ones. In order to protect the occupational health of interventional radiology workers, the monitoring of lens dose should be strengthened.
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Objective:To study the healthcare level (HCL) in China and its influencing factors.Methods:By using the data reported in the China statistical yearbook published by the National Bureau of Statistics and in other public literature, HCL was calculated in terms of the number of population and physicians in the whole country and various provinces. Multiple regression was used to analyze the relationship between HCL and regional population, area, number of administrative divisions and gross domestic product (GDP). Pearson correlation analysis was applied to analyze the relationship between healthcare level and medical radiation frequency. Results:Since 2015, Chinese HCL value was lower than 1 000, but there were two provinces with HCL value greater than 1 000 in 2019. Population and GDP were the influencing factors for the HCL, with correlation coefficients of 0.416 and -0.583, respectively. There was a correlation between HCL and medical exposure frequency of Chinese population( r= -0.620, P=0.028). Conclusions:Chinese HCL value was 542 in 2020, but there has been great differences between various provinces. HCL as an indicator of medical exposure assessment needs further research in China.
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Objective:To understand the non-uranium miners′ awareness of radon and health risks in China and analyze the relevant influencing factors, in order to provide research basis for radiological protection institutions and employers to carry out radon health education.Methods:Male miners in 32 typical non-uranium mines from 11 provinces were selected by using cluster random sampling method from June 2020 to December 2021. The awareness of radon and health risks was investigated, and the influencing factors were analyzed by binary logistic regression model.Results:A total of 1 184 non-uranium miners were investigated, and the radon awareness rate of them was 19.17%. 36.56% of the non-uranium miners heard about radon knew the radon health risks accurately, and 18.06% could identify the measures to reduce radon concentration correctly. Univariate analysis showed that the radon awareness rate of non-uranium miners varied with different education levels, labor relations, post categories, and regions ( χ2=55.92, 21.89, 64.31, 11.26, P<0.05 ). The result of logistic regression analysis showed that a bachelor degree or above, regular employee, administrative personnel and technical personnel were influencing factors of the radon awareness level ( χ2=12.81, 6.58, 5.66, 21.44, P<0.05 ). There was no statistically significant difference of radon awareness rate in different ages, working years, regions, and smoke groups ( P>0.05 ). Conclusions:The awareness level of radon and health risks of non-uranium miners was relatively low in China. Radiological protection institutions and employers should strengthen education and training of radon related knowledge in non-uranium miners through mass media, on-duty training, contract notification and workplace publicity board notification, so as to improve their personal protection consciousness.
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Since the implementation of the Measures for the Management of Radiation Workers’ Occupational Health in November 2007, it has played an extremely important role in protecting the occupational health of radiation workers. There are more than 700 000 radiation workers in about 100 000 workplaces with potential radiation exposure, as well as a large number of miners exposed to high levels of radon. As the radiation health monitoring project suggests, measures of occupational health management such as personal dose monitoring and occupational health examination of radiation workers have been widely implemented and achieved good results in the protection of radiation workers. However, the risks of chromosomal aberration and specific turbidity of the eye lens of radiation workers have increased in high-risk positions such as interventional radiology, nuclear medicine, and industrial flaw detection. The control of high radon exposure in miners needs to be strengthened. It is necessary to adapt to the new situation in view of new challenges and actively promote the revision of the Measures for the Management of Radiation Workers’ Occupational Health, so as to further improve the occupational health management of radiation workers in China.
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@#<b>Objective</b> To obtain the medical exposure frequency data of residents through a questionnaire survey on mobile phone networks in the community, and to analyze the main influencing factors. <b>Methods</b> A snowball sampling method was used to expand the sampling from medical staff in a county hospital to the community. The questionnaire included personal information such as occupation category, type of medical insurance, and education level as well as basic radiation-related knowledge and medical exposure type and frequency of respondents received in 2021. A logistic regression model was used to analyze the influencing factors of medical exposure. <b>Results</b> A total of 223 respondents were investigated, and 12.56% of them received radiological diagnosis and radiotherapy in 2021. The proportion of males receiving medical exposure was significantly higher than that of females (19.64% <i>vs</i> 10.18%). The likelihood of the person receiving medical exposure increased considerably with age, with the proportion of residents receiving medical exposure at 20, 30, 40, and 50 years of age being 6.25%, 7.95%, 19.23%, and 33.33%, respectively. Of persons who received medical exposure, 57.14% underwent CT scans. Persons participating in the new rural cooperative medical system were likely less to receive radiological diagnosis and radiotherapy than urban workers and residents (<i>OR</i> = 0.55, <i>CI</i>:0.13-2.23, <i>P</i> > 0.05). <b>Conclusion</b> Questionnaire survey in the community can obtain more information about the medical exposure of residents, and age and type of medical insurance are important factors affecting the frequency of medical exposure.
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The lens of the eye has been recognized as one of the most radiosensitive tissues. It has been known that a radiation dose of 0.5 Gy or higher can induce radiation cataract. Studies have also demonstrated that long-term exposure to low-dose radiation can increase the risk of lens opacity. However, the specific biologic mechanism of lens opacity induced by low-dose ionizing radiation is still unclear. Many mechanism chains may induce opacity independently or jointly, such as genomic damage in lens epithelial cells, oxidative stress, defects in intercellular communication, and inflammatory reaction, and genetic and epigenetic factors may also play a role. This paper briefly reviews the mechanisms of low-dose ionizing radiation inducing lens opacity as well as the role of genetic susceptibility in its development and progression, in order to provide a scientific reference for the prevention and control of this disease.
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Objective:To explore the probability of causation method ology of male breast cancer and to provide theoretical basis for the diagnosis of occupational radiogenic male breast cancer in China.Methods:Using the male excess relative risk model (EAR) fitted from the Japanese atomic bomb survivors and the female excess absolute risk model (ERR) provided by the Biological Effect of Ionizing Radiation Committee VII (BEIRVII), the breast dose and the probability of causation of the previous case of male breast cancer were calculated.Results:The average probability of causation ( PC) calculated by male ERR model was 94.6%, and the upper limit of 95% PC was 98.3%. Using female EAR model and female breast cancer incidence, the average PC was 70.3%, and the upper limit of 95% PC was 153.3%. when male breast cancer incidence was used, the average PC was 99.2%.By both methods, the male breast cancer patient could be determined to be caused by occupational radiation exposure. Conclusions:The upper limit of 95% PC calculated by female EAR model and female breast cancer incidence was higher than that by male ERR model.The uncertainty of probability of causation for female EAR model still need further research. Occupational radiogenic male breast was proposed to listed in occupational radiogenic neoplasms, which will make the list more perfect and scientific and reasonable to meet potential claims.
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Objective:To estimate the attribution share of residents′lung cancer caused by indoor Radon.Methods:Based on the 2015 lung cancer mortality, all-cause mortality from China together with nationally representative smoking rate and the average indoor radon concentration of 30 Bq/m 3, the relatively authoritative and applicable EPA/BEIR-VI risk model was used to predict the lung cancer mortality caused by indoor radon exposure. Results:The excess relative risk (ERR) of indoor radon-related lung cancer mortality among the male non-smokers is higher than that of smokers. For the age-group above 50, the male smokers and male non-smokers have the highest ERR values, which were 0.511 and 0.230, respectively. Assuming the exposure incurred starting at age 0 with the same radon concentration, the lifetime risk of men and women non-smokers is higher than that of the smokers of the same gender. The higher the radon concentration, the higher the lifetime risk of lung cancer. Assuming that the radon concentration level in China is 30 Bq/m 3, the number of deaths from indoor radon-related lung cancer in 2015 is about 55 512. According to this, about 6.62% of lung cancers are caused by indoor radon exposure. If we assume that radon concentration levels are 40 Bq/m 3and 70 Bq/m 3 in China, approximately 8.82% and 15.38% of lung cancer deaths can be attributed to indoor radon exposure. Conclusions:Indoor radon exposure is an important environmental factor that causes Chinese residential lung cancer. Effective measures should be taken to prevent and control the increasing indoor radon levels. In order to accurately assess risk of lung cancer morality caused by indoor radon, more detailed data such as the indoor radon level in China are needed.
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In March 2011, a nuclear accident happened and released a large amount of radionuclides into the environment in Fukushima, Japan. This review introduced the latest findings on the relationship between childhood thyroid cancer and radiation exposure after the accident in Fukushima. Many reports suggested that there was no accurate correlation between the incidence of childhood thyroid cancer and the local external dose due to the accident at the Fukushima Daiichi nuclear power, while the relationship between the two varied with method of dose calculation and statistics. Also there was no clear evidence that radiation exposure had a negative impact on children′s thyroid, and the increased incidence of thyroid cancer may be due to over-screening.
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Objective:To analyze distributions of dose range, occupational category, and causes of abnormal dose values from individual dose monitoring of radiation workers and to provide recommendations for improving the quality of individual monitoring data and occupational health management in medical institutions.Methods:The data of individual dose monitoring result exceeding 1.25 mSv in a single monitoring cycle, collected by Occupational Health System for Radiology Facilities’ on National Radiological Health Information Platform, was analyzed.Results:A total of 1 113 abnormal dose values were detected in 31 provinces in 2020, with an abnormal rate of 2.48‰, of which workers of diagnostic radiology and interventional radiology accounted for 68.01% and 18.78%, respectively. The dose distribution of abnormal dose values was mainly between 1.25 and 5 mSv. The abnormal dose values were mainly caused by improperly wearing or using personal dosimeters, accounting for 63.88%. Workers for whom the dose values was abnormal due to increased workload accounted for 12.32%, with an average annual individual dose of 5.14 mSv. There was no statistically significant difference in annual individual dose among radiation workers between different occupational groups( P>0.05). Conclusions:Education and training on radiation protection for radiation workers should be strengthened, and a specific and feasible system for radiation protection management, as well as a reward and punishment system, should be established in order to reduce the occurance of the improper wearing of personal dosimeters. Great attention should be paid to occupational exposure of workers in diagnostic radiology and interventional radiology, and a work shift system should be conducted to reduce individual dose levels. It is recommended that standard verification procedures for abnormal dose values from individual dose monitoring should be developed to improve the quality of individual monitoring data.
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Chinese National Standards GBZ 98-2020 Health Requirements and Surveillance Specifications for Radiation Worker was published and will replace the current standards GBZ 98-2017 Health Requirements for Radiation Workers and GBZ 235-2011 Specifications for Occupational Health Surveillance for Radiation Workers from May 1 in 2021. The significance of this new National Standards, the background, basic principles, basis of revision of important indicators and the matters needing attention in the application of the standard are described in detail, especially for the medical institutions carrying out occupational health examination requirements, the determination of occupational health examination items, examination method and examination reports, so as to avoid the possible misunderstandings and doubts in using the standards.
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With the development of high-throughput sequencing technology, the high-dimensional massive data obtained in omics study puts forward new requirements for statistical analysis. In this case, the traditional theory of single hypothesis testing is no longer applicable, and the issue of multiple hypothesis testing has received increasing attention. This paper introduced three commonly used error measures in multiple testing-family-wise error rate (FWER), false discovery rate (FDR), and positive false discovery rate (pFDR), and the control process in radiobiological omics data analysis, in order to provide a reference for statistical analysis of radiobiological data.
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The rapid development of medical application of ionizing radiation has seen a range of safety and protection problems that might be of importance. This paper aims to introduce the current situation and existing problems in the public medical exposure, and to propose the relevant suggestions, based on a combination of judgment of medical radiation exposure justification, quality assurance and control of equipment in radiodiagnosis and radiotherapy, occupational protection of radiation workers, and health effects on patients undergoing radiodiagnosis and radiotherapy.
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Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.
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Objective To understand the present state of radiological diagnosis and treatment resources allocation and to provide data support for the health administrative department to further optimize the allocation of resources in Linyi. Methods All hospitals which conducted radiological diagnosis and treatment in the city were surveyed. The data were analyzed by using SPSS software. Results There were 305 radiological diagnosis and treatment institutions, with 943 sets of radiological diagnosis and treatment equipment in Linyi. There were 0.89 sets of diagnostic and therapeutic equipment per 10000 people, and the average number of diagnostic and therapeutic equipment per institution in urban areas is 1.48 times that in county areas. There were 2208 radiological diagnosis and treatment staff in the city, and each hospital had 7.24 radiation staff, among which the number ofin tertiary, secondary, primary and unrated hospitals was 89.63, 17.64, 3.37 and 2.77, respectively. Conclusion The allocation of Diagnostic Radiology equipment is out of balance in Linyi, and the large-scale Diagnostic Radiology equipment is less and distributed centrally. The number of diagnostic and therapeutic radiographers per 10000 people is insufficient and unevenly distributed. Radiological diagnosis and treatment resources should be allocated scientifically to promote balanced development among regions and optimize the allocation of resources.
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Objective:To investigate the allocation of radiation protection equipment and status of radiological protection management for radiation workers in hospitals nationwide.Methods:A descriptive analysis was conducted of the data reported from the investigated hospitals based the data for 2019 available from the National Radiological Health Information Platform.Results:A total of 3 806 hospitals were investigated in 2019, including 609 tertiary hospitals, 1 421 secondary hospitals, 1 776 primary and ungraded hospitals. Large differences had been shown in the number of radiation workers in different grade hospitals. The average number of radiation workers were found to be, respectively, 99 in tertiary hospitals, 19 in secondary hospitals, 2 in primary and/or ungraded hospitals. Interventional radiology and nuclear medicine workers were equipped seperately with 0.40 and 0.43 pieces of lead apron, 0.27 and 0.31 lead caps, 0.38 and 0.45 lead rubber neck sleeves, 0.18 and 0.08 pairs of lead rubber gloves and 0.31 and 0.22 pairs of lead glasses. No personal alarming dosimeter was available in 15.25% hospitals where radiotherapy was performed, nor radiation surveillance meter in 27.90% such hospitals. In the hospitals considered, 88.13% workers were granted the Radiation Worker Cetificate and 83.69% received the on-the-job radiation protection training. The number of monitored workers accounted for 99.20%, of which 0.40% received the personal annual dose Hp(10)≥20 mSv. The occupational health surveillance files that had been completed reached 98.05% of the total and the on-the-job radiation workers who had passed the occupational health examination made up to 96.00%. It was advised that, of 76 627 radiation workers who received the 2019 health examination, 0.88% should get out of radiation work for the being time and 0.11% should not continue for this work. Conclusions:The considerably large proportion of radiation workers in China have received individual dose monitoring and occupational health examination. Radiological diagnosis and therapy departments should enlarge the allocation of radiation monitoring and personal protection equipment for radiaton workers in their hospitals.
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The article briefly described the frequency of CT scans and the development trend of CT exposure doses in children,and introduced the main method and achievements in the cancer risk evaluation of pediatric CT scans in different time periods.This review will provide the references for optimizing the radiation dose of CT scans.
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The article briefly described the frequency of CT scans and the development trend of CT exposure doses in children, and introduced the main method and achievements in the cancer risk evaluation of pediatric CT scans in different time periods. This review will provide the references for optimizing the radiation dose of CT scans.
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Objective To study the estimation method of medical exposure frequency in China through the survey of diagnostic radiology and radiotherapy institutions in selected provinces.Methods A survey of medical exposure frequency was carried out involving 557 diagnostic radiology and radiotherapy institutions in 25 provinces.The correlation analysis and multiple linear regression analysis were conducted,with the fitting effects of the models with different variables being compared.Results The total medical exposure frequencies highly correlated with number of outpatient,number of equipment and number of radiation workers (| r| ＞0.5).Representative samples of the daily medical exposure workload were obtained by stratified random sampling from the survey data.Mathematical models were built using the multiple linear regression between total medical exposure frequency and hospital levels,number of outpatients,number of inpatients,number of equipment,and number of radiation workers.The total medical exposure frequency in 2016 was estimated to be 589 million examinations based on the models.In addition,the frequencies of medical procedures were derived using the robust regression and the median regression.Conclusions There are several methods for estimating the total medical exposure frequency.It is desirable to use the stratified random sampling combined with the published statistical and monitoring data.The representativeness of sample is critical.The specification and optimization of models also require further study.
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Objective To analyze the changes in distribution of occupational radiation cases reported from 2013 to 2017 in China and learn about the occupational health risks of radiation workers.Methods Descriptive analyses were made of regional distribution,disease category distribution,occupation category distribution and exposure mode distribution of these cases,according to the reports (2013-2017) of occupational radiation sickness from " Occupational Health of Radiation Workers Management System".Results There were 54 diagnostic radiology agencies for occupational radiation sickness in China that covered all provinces,autonomous regions and municipalities except Tibet and Production and Construction Corps of Xinjiang.A total of 106 new cases were reported from 2013 to 2017.Most of the cases were radiogenic neoplasm (43.40％),and chronic radiation sickness were from external exposure (16.98％) and radiation cataract (16.04％).Most of the cases (70.75％) were engaged in medical application and a small part of the cases (13.21％) engaged in industry application.Chronic exposure (80.19％) was the most frequent form of exposure mode,but acute exposure (5.66％) was very few.A part of cases (14.15％) were reported without exposure mode.Conclusions The morbidity of occupational radiation sickness declined generally in China and occupational health management of key workers should be strengthened continuously.