Analysis of radiation workers' dose records in the Korean National Dose Registry

Characteristics and Trends of Occupational Radiation Doses among Korean Radiation Workers (1984-2020)

ABSTRACT

This study identified characteristics of occupational radiation doses among Korean radiation workers from 1984-2020 using the National Dose Registry. The overall mean effective dose from 1984-2020 was 1.05 mSv y -1 , with the highest mean effective dose of 2.61 mSv y -1 for non-destructive testing workers. The mean effective dose gradually decreased from 2.97 mSv in 1984 to 0.34 mSv in 2020. The largest decline ratio between 1984 and 2020 was observed in educational institutions at 97.4% (0.84 mSv in 1984 and 0.02 mSv in 2020), followed by industries at 96.5% (2.55 mSv in 1984 and 0.09 mSv in 2020). Compared to 1984, the individual dose-distribution and collective dose-distribution ratios in 2020 decreased by 82.6-99% and 53.7-94.7%, respectively. This downward trend was consistent in all occupations, while decline characteristics were different depending on occupation types, work experience, and changes in radiation safety regulations. Considering that some changes in radiation doses in the registry could be solely based on changing the recording mode regardless of the actual changes in radiation doses, a careful understanding of radiation doses in the registry is particularly relevant for future epidemiological studies.

Estimation of the historical radiation dose of Korean radiation workers, 1961-1983

Accurate dosimetry plays a key role in evaluating the radiation-induced health risks of radiation workers. The National Dose Registry in Korea contains the dose records of radiation workers in nuclear-related occupations since 1984. Thus, radiation doses for workers before 1984 are often sparse or missing. This study aimed to estimate the historical radiation dose before 1984 for radiation workers in Korea based on dose reconstruction models. The dose reconstruction models were derived from the nationwide self-administered questionnaire survey and the personal badge doses for workers in the cohort of the Korean Radiation Worker Study. The mean estimated annual doses between 1984 and 2016 from the dose reconstruction model were 4.67-0.6 mSv, which closely matched the reported doses of 4.51-0.43 mSv. The mean estimated annual doses between 1961 and 1983 based on the exposure scenarios developed by factors associated with radiation doses ranged from 11.08 to 4.82 mSv. The mean estimated annual doses of individuals in the cohort from 1961 to 1983 ranged from 11.15 to 4.88 mSv. Although caution needs to be exercised in the interpretation of these estimations due to uncertainty owed to the nature of extrapolation beyond the range of observed data, this study offers a sense of the radiation doses for workers during Korea's early period of radiation-related activities, which can be a useful piece of information for radiation-induced health risk assessments.

Trends in Occupational Radiation Doses for U.S. Radiologic Technologists Performing General Radiologic and Nuclear Medicine Procedures, 1980-2015

Background Occupational doses to most medical radiation workers have declined substantially since the 1950s because of improvements in radiation protection practices. However, different patterns may have emerged for radiologic technologists working with nuclear medicine because of the higher per-procedure doses and increasing workloads. Purpose To summarize annual occupational doses during a 36-year period for a large cohort of U.S. radiologic technologists and to compare dose between general radiologic technologists and those specializing in nuclear medicine procedures. Materials and Methods Annual personal dose equivalents (referred to as doses) from 1980 to 2015 were summarized for 58 434 (62%) participants in the U.S. Radiologic Technologists (USRT) cohort who responded to the most recent mailed work history survey (years 2012-2014) and reported never regularly performing interventional procedures. Doses were partitioned according to the performance of nuclear medicine (yes or no, frequency, procedure type) by calendar year. Annual dose records were described by using summary statistics (eg, median and 25th and 75th percentiles). Results Median annual doses related to performance of general radiologic procedures decreased from 0.60 mSv (interquartile range [IQR], 0.10-1.9 mSv) in 1980 to levels below the limits of detection by 2015, whereas annual doses related to performance of nuclear medicine procedures remained relatively high during this period (median, 1.2 mSv; IQR, 0.12-3.0 mSv). Higher median annual doses were associated with more frequent (above vs below the median) performance of diagnostic nuclear medicine procedures (≥35 vs <35 times per week; 1.6 mSv [IQR, 0.30-3.3 mSv] and 0.9 mSv [IQR, 0.10-2.6 mSv]). Higher and more variable annual doses were associated with more frequent performance of cardiac nuclear medicine (≥10 times per week) and PET (nine or more times per week) examinations (median, 1.6 mSv [IQR, 0.30-2.2 mSv] and 2.2 mSv [IQR, 0.10-4.6 mSv], respectively). Conclusion Annual doses to U.S. radiologic technologists performing general radiologic procedures declined during a 36-year period. However, consistently higher and more variable doses were associated with the performance of nuclear medicine procedures, particularly cardiac nuclear medicine and PET procedures. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mettler and Guiberteau in this issue.

AN ARTIFICIAL NEURAL NETWORK-BASED MODEL FOR PREDICTING ANNUAL DOSE IN HEALTHCARE WORKERS OCCUPATIONALLY EXPOSED TO DIFFERENT LEVELS OF IONIZING RADIATION

We presented an artificial intelligence-based model to predict annual effective dose (AED) value of health workers. Potential factors affecting AED and the results of annual blood tests were collected from 91 radiation workers. Filter-based feature selection strategy revealed that the eight factors plate, red cell distribution width (RDW), educational degree, nonacademic course in radiation protection (hour), working hours per month, department and the number of procedures done per year and work in radiology department or not (0,1) were the most important predictors for AED. The prediction model was developed using a multilayer perceptron neural network and these prediction parameters as inputs. The model provided favorable accuracy in predicting AED value while a regression model did not. There was a strong linear relationship between the predicted AED values and the measured doses (R-value =0.89 for training samples and 0.86 for testing samples). These results are promising and show that artificial neural networks can be used to improve/facilitate dose estimation process.

OCCUPATIONAL EXPOSURE CHARACTERISTICS AND FACTORS ASSOCIATED WITH RADIATION DOSES AMONG KOREAN RADIATION WORKERS

This study identified occupational factors associated with radiation exposure in Korea. Survey data of 16 037 workers from 2016 to 2017, including lifestyle factors and occupational characteristics, were combined with the National Dose Registry. Higher average annual doses were observed in groups exhibiting health risk factors such as body mass index (BMI) and smoking. Average annual doses also differed according to occupational characteristics, including average daily working hours, use of radiation protection gear, calendar year of hiring and employment status. Moreover, the influence of different factors on radiation dose differed with occupations. In industrial radiography and nuclear power plants, average daily working hours were the most important factor determining worker radiation doses. In other occupations, such as education, industry and research, calendar year of hiring and duration of employment were the most important factors. This research indicates the need to consider the specific work procedures of occupations to determine exposure variations between or within facilities.

Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study

INTRODUCTION

The cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure.

METHODS AND ANALYSIS

Approximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose-response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status.

ETHICS AND DISSEMINATION

This study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings of the study will be disseminated through scientific peer-reviewed journals and be provided to the public, including radiation workers, via the study website (http://www.rhs.kr/) and onsite radiation safety education.

Radiation-related occupational cancer and its recognition criteria in South Korea

Ionizing radiation is a well-known carcinogen, and is listed as one carcinogenic agent of occupational cancer. Given the increase in the number of workers exposed to radiation, as well as the increase in concern regarding occupational cancer, the number of radiation-related occupational cancer claims is expected to increase. Unlike exposure assessment of other carcinogenic agents in the workplace, such as asbestos and benzene, radiation exposure is usually assessed on an individual basis with personal dosimeters, which makes it feasible to assess whether a worker’s cancer occurrence is associated with their individual exposure. However, given the absence of a threshold dose for cancer initiation, it remains difficult to identify radiation exposure as the root cause of occupational cancer. Moreover, the association between cancer and radiation exposure in the workplace has not been clearly established due to a lack of scientific evidence. Therefore, criteria for the recognition of radiation-related occupational cancer should be carefully reviewed and updated with new scientific evidence and social consensus. The current criteria in Korea are valid in terms of eligible radiogenic cancer sites, adequate latent period, assessment of radiation exposure, and probability of causation. However, reducing uncertainty with respect to the determination of causation between exposure and cancer and developing more specific criteria that considers mixed exposure to radiation and other carcinogenic agents remains an important open question.

Assessment of annual average effective dose status in the cohort of medical staff in Lithuania during 1991-2013

The use of radiation sources for various medical purposes is closely related to irradiation of the medical staff, which causes harmful effects to health and an increased risk of cancer. In total, 1463 medical staff who have been occupationally exposed to sources of ionising radiation (IR) had been monitored. Records with annual dose measurements (N = 19 157) were collected and regularly analysed for a 23-y period: from 01 January 1991 to 31 December 2013. The collected annual average effective dose (AAED) data have been analysed according to different socio-demographic parameters and will be used in future investigation in order to assess cancer risk among medical staff occupationally exposed to sources of IR. A thorough analysis of data extracted from medical staff's dose records allows one to conclude that the average annual effective dose of Lithuanian medical staff occupationally exposed to sources of IR was consistently decreased from 1991 (1.75 mSv) to 2013 (0.27 mSv) (p < 0.0001).

Occupational radiation exposure in Tanzania (1996-2010): status and trends

Data on occupational radiation exposure using the thermoluminescence dosimetry methodology in Tanzania for the years 1996-2010 are analysed and discussed. The results of the analysis indicate that over 80 % of the total collective dose was from diagnostic radiology. In addition, <1 % of workers received annual individual doses above 5 mSv, and there were no doses that exceeded the recommended limit of 20 mSv y(-1), except for one incidence in non-destructive testing. Furthermore, the trends in occupational exposure remained approximately constant and largely within the ranges of average doses in the literature. The status and trends in occupational exposure demonstrate that radiation protection conditions at the majority of workplace were adequate. Despite that, further optimisation is necessary due to large variations observed in the maximum individual doses over three 5-y sub-periods.

Brazilian external occupational dose management system

Brazil, a large country, with more than 120,000 workers under individual monitoring for ionising radiation, developed, more than 20 y ago, a centralised data bank for external occupational dose. This old database, however, presented some problems and does not satisfy any more Brazilian present needs, not allowing dose analysis reports, for example. Therefore, a new system that reduces manual tasks, provides system communication support, manages reports and improves data storage management is being developed. This paper describes this new web-based information system, named Brazilian External Occupational Dose Management database system--GDOSE.

Occupational radiation doses among diagnostic radiation workers in South Korea, 1996-2006

This study details the distribution and trends of doses of occupational radiation among diagnostic radiation workers by using the national dose registry between 1996 and 2006 by the Korea Food and Drug Administration. Dose measurements were collected quarterly by the use of thermoluminescent dosimeter personal monitors. A total of 61 732 workers were monitored, including 18 376 radiologic technologists (30 %), 13 762 physicians (22 %), 9858 dentists (16 %) and 6114 dental hygienists (9.9 %). The average annual effective doses of all monitored workers decreased from 1.75 to 0.80 mSv over the study period. Among all diagnostic radiation workers, radiologic technologists received both the highest effective and collective doses. Male radiologic technologists aged 30-49 y composed the majority of workers receiving more than 5 mSv in a quarter. More intensive monitoring of occupational radiation exposure and investigation into its health effects on diagnostic radiation workers are required in South Korea.

Whole-body doses of occupationally exposed female workers in Nigeria (1999-2001)

The work described in this note is based on the national dose registry of radiation workers in Nigeria kept by the Federal Radiation Protection Service. In each of the three years (1999-2001) used for this analysis, the number of male radiation workers was more than that of female radiation workers in both medicine and industry. The ratio of the number of female radiation workers to that of their male counterparts, however, is smaller in industry. The mean of the annual doses of all radiation workers increased from 3.6 mSv in 1999 to 4.7 mSv in 2000 and to 7.7 mSv in 2001. This increase was a result of the yearly increase in mean annual doses to radiation workers in industry. In the industrial category, the mean annual doses of female radiation workers were higher than those of their male counterparts in 1999 and 2001 in both occupation categories. In 2000, while the mean annual doses were the same for both male and female radiation workers in the medical category, the mean annual dose of male radiation workers was higher than that of female radiation workers in industry. Female radiation workers received the highest annual doses in 1999 and 2001. These results indicate the need for the regulatory authority to pay more careful attention to the control of female radiation workers' exposures.