MEDICAL RESPONSE TO A RADIOLOGICAL ACCIDENT INVOLVING AN IRIDIUM-192 SOURCE IN NANJING, CHINA.

On 7 May 2014, a radiological accident involving a lost 192Ir source occurred in Nanjing, China, and overexposure of a worker occurred. After the accident, several national agencies specialized in medical response to radiation emergencies collaborated to carry out clinical case management and to offer psychological assistance to the affected workers and members of the public. In this article, the medical management of the victim is summarized and outcomes are shared in order to improve medical preparedness and response for a nuclear or radiological emergency. This case demonstrated that providing rapid, accurate, credible and consistent information to the public through the media, public health education and psychological assistance to the affected workers and members of the public, contribute to mitigation of psychological impact of such emergencies.

Estimation of the occupational exposure dose for medical diagnostic X-ray workers in Jiangsu, China, using a retrospective dosimetry method.

Medical diagnostic X-ray workers are one occupational group that has exposure to continuous low doses of external radiation over their working lifetimes. Current ICRP recommendations [ICRP. Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP 1991;21 (1-3)] state that there is no threshold of stochastic effects induced by radiation exposure such as carcinogenicity or genetic defects, and that the frequency of the effects is proportional to the amount of exposure to low levels of radiation, which is measured by radiation dose. In order to determine the dose information for this special occupational group over their working lifetimes (focusing particularly on workers exposed before 1985, when there was no personal dose monitoring), a sampling survey of the occupational history for these workers was conducted and an occupational history database was established. Using the database and retrospective dosimetry method of Zhang et al. (A retrospective dosimetry method for occupational dose for Chinese medical diagnostic X-ray workers. Radiat Prot Dosimetry 1998;77:69-72), the annual occupational exposure dose for medical diagnostic X-ray personnel working between 1950 and 2011 was computerized. Some annual dose results estimated using the proposed method were numerically in good agreement with the monitoring results. The average of the annual dose for these medical workers peaked during the mid-1950s and then declined, reaching very low levels by the 1990s and remaining at those levels thereafter. The trend in the annual dose is similar to that reported by earlier studies by Zielinski et al. (Health outcomes of low-dose ionizing radiation exposure among medical workers: a cohort study of the Canadian national dose registry of radiation workers. Int J Occup Med Environ Health 2009;22:149-56). The dose calculated by the retrospective dosimetry method can truly indicate the degree of the workers' exposure in their medical X-ray diagnostic work.

Nested Case-control Study of Occupational Radiation Exposure and Breast and Esophagus Cancer Risk among Medical Diagnostic X Ray Workers in Jiangsu of China.

Medical diagnostic X-ray workers are one occupational group that expose to the long-term low-dose external radiation over their working lifetime, and they may under risk of different cancers. This study aims to determine the relationship between the occupational X-ray radiation exposure and cancer risk among these workers in Jiangsu, China. We conducted Nested case-control study to investigate the occupational X-ray radiation exposure and cancer risk. Data were collected through self-administered questionnaire, which includes but not limits to demographic data, personal behaviors and family history of cancer. Retrospective dose reconstruction was conducted to estimate the cumulative doses of the x-ray workers. Inferential statistics, t-test and 2 tests were used to compare the differences between each group. We used the logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of cancer by adjusting the age, gender. All 34 breast cancer cases and 45 esophageal cancer cases that detected in a cohort conducted among health workers between 1950~2011 were included in this presented study, and 158 cancer-free controls were selected by frequency-matched (1:2). Our study found that the occupational radiation exposure was associated with a significantly increased cancer risk compared with the control, especially in breast cancer and esophageal cancer (adjusted OR=2.90, 95% CI: 1.19-7.04 for breast cancer; OR=4.19, 95% CI: 1.87-9.38 for esophageal cancer, and OR=3.43, 95% CI: 1.92-6.12 for total cancer, respectively). The occupational X-ray radiation exposure was associated with increasing cancer risk, which indicates that proper intervention and prevention strategies may be needed in order to bring down the occupational cancer risk.

Knowledge of and attitude to nuclear power among residents around Tianwan Nuclear Power Plant in Jiangsu of China.

AIMS: The aims of this paper were to determine the level of knowledge of and attitude to nuclear power among residents around Tianwan Nuclear power plant in Jiangsu of China. DESIGN: A descriptive, cross-sectional design was adopted. PARTICIPANTS: 1,616 eligible participants who lived around the Tianwan nuclear power plant within a radius of 30km and at least 18 years old were recruited into our study and accepted epidemiological survey. METHODS: Data were collected through self-administered questionnaires consisting of a socio-demographic sheet. Inferential statistics, t-test, ANOVA test and multivariate regression analysis were used to compare the differences between each subgroup and correlation analysis was conducted to understand the relationship between different factors and dependent variables. RESULTS: Our investigation found that the level of awareness and acceptance of nuclear power was generally not high. Respondents' gender, age, marital status, residence, educational level, family income and the distance away from the nuclear power plant are important effect factors to the knowledge of and attitude to nuclear power. CONCLUSIONS: The public concerns about nuclear energy's impact are widespread. The level of awareness and acceptance of nuclear power needs to be improved urgently.

Association between genetic polymorphism of the angiotensin-converting enzyme and diabetic nephropathy: a meta-analysis comprising 26,580 subjects.

INTRODUCTION: The effect of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on risk of diabetic nephropathy (DN) is still conflicting. The present meta-analysis was performed to evaluate the overall risk of this polymorphism associated with DN in different groups. MATERIALS AND METHODS: A predefined search was performed on 14,108 DN cases and 12,472 controls from 63 published studies by searching electronic databases and reference lists of relevant articles. RESULTS: In this meta-analysis, we found a significant association between the ACE I/D polymorphism and the risk of DN for all genetic models (ID versus II: odds ratio [OR] = 1.12, 95% confidence interval [CI] 1.02-1.24; DD versus II: OR = 1.27, 95% CI 1.13-1.44; allele contrast: OR = 1.15, 95% CI 1.08-1.23; dominant model: OR = 1.18, 95% CI 1.07-1.31; and recessive model: OR = 1.18, 95% CI 1.08-1.30, respectively). In stratified analysis by ethnicity and DM type, we further found that the Asian group with type 2 diabetes mellitus (T2DM) showed a significant association for all genetic models (ID versus II: OR = 1.25, 95% CI 1.07-1.47; DD versus II: OR = 1.57, 95% CI 1.24-1.98; allele contrast: OR = 1.30, 95% CI 1.15-1.46; dominant model: OR = 1.37, 95% CI 1.10-1.69; and recessive model: OR = 1.34, 95% CI 1.15-1.56, respectively). CONCLUSIONS: Our study suggested that the ACE I/D polymorphism may contribute to DN development, especially in the Asian group with T2DM.

Common BRCA1 and BRCA2 mutations in breast cancer families: a meta-analysis from systematic review.

A number of molecular epidemiological studies have been conducted the screening for BRCA1 and BRCA2 mutations in breast cancer patients with a positive family history of breast and/or ovarian cancer and reported many common mutations in BRCA1 and BRCA2 associated in breast cancer in different population and different ethnicity. However, it's still lack of a systematic analysis on these mutations. To comprehensively evaluate the frequency and distribution of common BRCA1 and BRCA2 mutations which associated with breast cancer risk, we address this issue through system review and meta-analysis on 29 relevant published studies by conducting a literature search on PubMed and CNKI. 20 common founder germline mutations were identified from all 29 studies and 4 of BRCA1 (5382insC, 185delAG, 3819del5 and 4153delA) and 2 of BRCA2 (4075delGT, 5802del4) mutations were repeatedly reported twice or more in different articles, respectively. For the BRCA1, after conducting meta-analysis, we found that the overall frequency of 5382insC was 0.09 (95% CI 0.06-0.12), the frequency of 185delAG was 0.07 (95% CI 0.01-0.13), the frequency of 3819del5 was 0.02 (95% CI 0.01-0.04) and the frequency of 4153delA was 0.06 (95% CI 0.03-0.09). For the BRCA2, the overall frequency of 4075delGT was 0.02 (95% CI 0.00-0.03) and the frequency of 5802del4 was 0.07 (95% CI 0.04-0.11). This article provides a set of common mutations for BRCA1 and BRCA2 mutation carriers and the results may help to explore frequencies of BRCA1 and BRCA2 mutations in a given population and will be of significance both for diagnostic testing and for epidemiological studies.