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Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
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Neeman BB, Raisin G, Chertin B, Qadan S, Kafka I. Adopting ultrasound guided PCNL in nephrolithiasis management. Urologia 2024; 91:337-341. [PMID: 37846747 DOI: 10.1177/03915603231198554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
INTRODUCTION This study aimed to evaluate the learning curve associated with the adoption of US guided PCNL and demonstrate that it can be carried out safely with results comparable to those obtained using standard PCNL. METHODS Prospective study with 65 patients who underwent PCNL between 2019 and 2020. all procedures were performed in supine position and an initial attempt to gain access to the kidney using US was made. RESULTS Mean procedure duration was 69.5 ± 27.8 min. Fluoroscopy was used with a mean dose of 276.68 ± 560.71 (cGycm3) and mean fluoroscopy time 40.25 ± 77.69 (s). Throughout the study there was a steady decrease in the use of fluoroscopy and amount of radiation to gain access to the kidney to only 25% at the study end. 76.5% of the patients were stone free at follow-up. Complication rate was 9.2%. CONCLUSIONS Fluoroless US guided PCNL is safe, feasible and reproducible procedure.
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Affiliation(s)
- Binyamin B Neeman
- Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Galia Raisin
- Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Boris Chertin
- Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Saeed Qadan
- Operating Room-Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Ilan Kafka
- Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
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Çobanoğlu H, Çayır A. Occupational exposure to radiation among health workers: Genome integrity and predictors of exposure. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2024; 893:503726. [PMID: 38272632 DOI: 10.1016/j.mrgentox.2024.503726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
The current study aimed to investigate genomic instabilities in healthcare workers who may experience varying levels of radiation exposure through various radiological procedures. It also sought to determine if factors related to the work environment and dosimeter reading could effectively explain the observed genomic instabilities. Utilizing the cytokinesis-block micronucleus assay (CBMN) on peripheral blood lymphocytes, we assessed a spectrum of genomic aberrations, including nucleoplasmic bridge (NPB), nuclear budding (NBUD), micronucleus (MN) formation, and total DNA damage (TDD). The study uncovered a statistically significant increase in the occurrence of distinct DNA anomalies among radiology workers (with a significance level of P < 0.0001 for all measurements). Notably, parameters such as total working hours, average work duration, and time spent in projection radiography exhibited significant correlations with MN and TDD levels in these workers. The dosimeter readings demonstrated a positive correlation with the frequency of NPB and NBUD, indicating a substantial association between radiation exposure and these two genomic anomalies. Our multivariable models identified the time spent in projection radiography as a promising parameter for explaining the overall genomic instability observed in these professionals. Thus, while dosimeters alone may not fully explain elevated total DNA damage, intrinsic work environment factors hold potential in indicating exposure levels for these individuals, providing a complementary approach to monitoring.
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Affiliation(s)
- Hayal Çobanoğlu
- Health Services Vocational College, Çanakkale Onsekiz Mart University, Çanakkale 17100, Turkey
| | - Akın Çayır
- Health Services Vocational College, Çanakkale Onsekiz Mart University, Çanakkale 17100, Turkey.
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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Niu K, Liu Q. Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995. Occup Environ Med 2023; 80:687-693. [PMID: 37918914 DOI: 10.1136/oemed-2023-108875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers. METHODS This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose. RESULTS 1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers. CONCLUSIONS These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.
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Affiliation(s)
- Yeqing Gu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Jinhan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Chang Xu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Liqing Du
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Qin Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaihua Ji
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Ningning He
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Manman Zhang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Huijuan Song
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaijun Niu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
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Ren Z, Ren Y, Bai X, Shang P, Li G. Analysis of factors associated with abnormal thyroid function among medical staff in radiotherapy departments. Front Public Health 2023; 11:1225879. [PMID: 37663838 PMCID: PMC10470063 DOI: 10.3389/fpubh.2023.1225879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023] Open
Abstract
Objective To understand abnormal thyroid function and its associated factors among medical staff in radiotherapy departments. Methods Data related to medical staff in radiotherapy departments who met the inclusion and exclusion criteria were analyzed from September to December 2022 in Shenyang, Liaoning Province, including basic personal and lifestyle habits, work information, and scores on the Depression Self-Assessment Scale, Perception Stress Scale, and the Generalized Anxiety Scale. Data analysis was performed using the χ2 test and binary logistic regression. Results Among 484 medical staff in the radiotherapy department, 147 (30.4%) had abnormal thyroid function. Binary logistic regression analysis showed that age, years of work, smoking, occupational exposure, smoking, late-night snacking habits, depression, and stress perception were factors associated with abnormal thyroid function among medical staff in radiotherapy departments; on the other hand, physical exercise was a protective factor. Conclusion The positive rate of thyroid dysfunction among medical personnel in the radiology department is relatively high. It is necessary to strengthen health education and awareness among relevant practitioners and improve the coverage of occupational disease prevention and control education.
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Affiliation(s)
- Ziwei Ren
- Department of Radiotherapy, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yanwei Ren
- Department of Paediatrics, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xinghua Bai
- Department of Radiotherapy, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Puyu Shang
- Department of Radiotherapy, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Guang Li
- Department of Radiotherapy, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Milman RJ, McCollough CH, Sechopoulos I. Radiation safety: minimise risks by properly positioning patients, equipment, and operators. BMJ 2023; 381:p1472. [PMID: 37385644 DOI: 10.1136/bmj.p1472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Affiliation(s)
- Rebecca J Milman
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Cynthia H McCollough
- CT Clinical Innovation Center and X-ray Imaging Core, Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ioannis Sechopoulos
- Advanced X ray Tomographic Imaging Lab, Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, The Netherlands
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Cui L, Tian Q, Feng Z, Ma Y. What happened when medical staff in Beijing, China wore over-apron dosemeters? RADIATION PROTECTION DOSIMETRY 2023:7185476. [PMID: 37247844 DOI: 10.1093/rpd/ncad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023]
Abstract
The wearing method of personal dosemeters for medical staff changed from under to outside the operator's protective apron in April 2020. We measured the radiation dose Hp(10) for medical staff in Beijing from September 2020 to October 2021. The study population consisted of 3291 medical staff. All participants were divided into three groups. After excluding unusually low doses, the collected data higher than the detection limit involved 811 (7.8%) of 10 395 readings from 479 (14.6%) of 3291 staff. The mean equivalent dose was 1.4 mSv/3 months, with an SD of 2.3 mSv. The calculated average annual effective doses of radiation workers in the three groups after the interventional procedures from September 2020 to October 2021 ranged from 0.47 to 0.63 mSv/year, with median values of 0.32, 0.23 and 0.26 mSv/year, respectively.
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Affiliation(s)
- Limeng Cui
- Department of Radiation Protection, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Qingxiang Tian
- Department of Radiation Protection, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zechen Feng
- Department of Radiation Protection, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yongzhong Ma
- Department of Radiation Protection, Beijing Center for Disease Prevention and Control, Beijing, China
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Pilkington I, Sevenoaks H, James E, Eastwood D. Protecting female healthworkers from ionising radiation at work. BMJ 2023; 381:e075406. [PMID: 37045449 DOI: 10.1136/bmj-2023-075406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
| | | | - Emily James
- King's College Hospital NHS Foundation Trust, London, UK
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Boice JD, Cohen SS, Mumma MT, Howard SC, Yoder RC, Dauer LT. Mortality among medical radiation workers in the United States, 1965-2016. Int J Radiat Biol 2023; 99:183-207. [PMID: 34731066 DOI: 10.1080/09553002.2021.1967508] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Estimates of radiation risks following prolonged exposures at low doses and low-dose rates are uncertain. Medical radiation workers are a major component of the Million Person Study (MPS) of low-dose health effects. Annual personal dose equivalents, HP(10), for individual workers are available to facilitate dose-response analyses for lung cancer, leukemia, ischemic heart disease (IHD) and other causes of death. MATERIALS AND METHODS The Landauer, Inc. dosimetry database identified 109,019 medical and associated radiation workers first monitored 1965-1994. Vital status and cause of death were determined through 2016. Mean absorbed doses to red bone marrow (RBM), lung, heart, and other organs were estimated by adjusting the recorded HP(10) for each worker by scaling factors, accounting for exposure geometry, the energy of the incident photon radiation, sex of the worker and whether an apron was worn. There were 4 exposure scenarios: general radiology characterized by low-energy x-ray exposure with no lead apron use, interventional radiologists/cardiologists who wore aprons, nuclear medicine personnel and radiation oncologists exposed to high-energy photon radiation, and other workers. Standardized mortality ratio (SMR) analyses were performed. Cox proportional hazards models were used to estimate organ-specific radiation risks. RESULTS Overall, 11,433 deaths occurred (SMR 0.60; 95%CI 0.59,0.61), 126 from leukemia other than chronic lymphocytic leukemia (CLL), 850 from lung cancer, and 1654 from IHD. The mean duration of monitoring was 23.7 y. The excess relative rate (ERR) per 100 mGy was estimated as 0.10 (95% CI -0.34, 0.54) for leukemia other than CLL, 0.15 (0.02, 0.27) for lung cancer, and -0.10 (-0.27, 0.06) for IHD. The ERR for lung cancer was 0.16 (0.01, 0.32) among the 55,218 male workers and 0.09 (-0.19, 0.36) among the 53,801 female workers; a difference that was not statistically significant (p-value = 0.23). CONCLUSIONS Medical radiation workers were at increased risk for lung cancer that was higher among men than women, although this difference was not statistically significant. In contrast, the study of Japanese atomic bomb survivors exposed briefly to radiation in 1945 found females to be nearly 3 times the radiation risk of lung cancer compared with males on a relative scale. For medical workers, there were no statistically significant radiation associations with leukemia excluding CLL, IHD or other specific causes of death. Combining these data with other cohorts within the MPS, such as nuclear power plant workers and nuclear submariners, will enable more precise estimates of radiation risks at relatively low cumulative doses.
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Affiliation(s)
- John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | | | - Michael T Mumma
- International Epidemiology Institute, Rockville, MD, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sara C Howard
- ORISE Health Studies Program, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | | | - Lawrence T Dauer
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Modarai B, Haulon S, Ainsbury E, Böckler D, Vano-Carruana E, Dawson J, Farber M, Van Herzeele I, Hertault A, van Herwaarden J, Patel A, Wanhainen A, Weiss S, Esvs Guidelines Committee, Bastos Gonçalves F, Björck M, Chakfé N, de Borst GJ, Coscas R, Dias NV, Dick F, Hinchliffe RJ, Kakkos SK, Koncar IB, Kolh P, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Document Reviewers, Bacher K, Brountzos E, Fanelli F, Fidalgo Domingos LA, Gargiulo M, Mani K, Mastracci TM, Maurel B, Morgan RA, Schneider P. Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety. Eur J Vasc Endovasc Surg 2023; 65:171-222. [PMID: 36130680 DOI: 10.1016/j.ejvs.2022.09.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023]
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Koterov AN, Tukov AR, Ushenkova LN, Kalinina MV, Biryukov AP. Average Accumulated Radiation Doses for Global Nuclear Workers: Low Doses, Low Effects, and Comparison with Doses for Medical Radiologists. BIOL BULL+ 2022. [DOI: 10.1134/s106235902212007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Shi HM, Sun ZC, Ju FH. Recommendations for reducing exposure to medical X-ray irradiation (Review). MEDICINE INTERNATIONAL 2022; 2:22. [PMID: 36699506 PMCID: PMC9829209 DOI: 10.3892/mi.2022.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023]
Abstract
With the increasing frequency of X-ray examinations in clinical medicine, public concern regarding the harm caused by exposure to X-ray radiation is also increasing. However, some physicians are not completely aware of the dangers of exposure to X-ray irradiation. Individuals specialized in this field, including physicians, have a better understanding of these dangers, which limits the use of X-rays in medicine. The present study aimed to address strategies for reducing the harm caused by exposure to medical X-rays and increase public awareness regarding X-ray radiation. Through a literature search and review, combined with the current status of clinical X-ray examination and the authors' professional experience, the present study highlights the importance of reducing X-ray exposure, and proposes several specific recommendations and measures for reducing the frequency or dose of X-ray irradiation. On the whole, the finding discussed in the present review suggest the minimal use of medical X-ray examinations and that alternative tests should be selected whenever possible. When medical X-ray screening and treatments are necessary, the risk-benefit ratio should be assessed, possibly aiming to achieve avoidable exposure. Further attention should be paid to protect sensitive glands and reduce the risks in children.
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Affiliation(s)
- Hai-Min Shi
- Department of Gynecology and Obstetrics Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Gynecology and Obstetrics Medicine, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Zhi-Chao Sun
- Department of Medical Imaging, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Medical Imaging, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Fang-He Ju
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Respiratory Medicine, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China,Correspondence to: Dr Fang-He Ju, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, Zhejiang 310006, P.R. China
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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Sun X, Wang J, Kitahara CM, de Gonzalez AB, Niu K, Liu Q. Low-dose ionizing radiation exposure and risk of leukemia: results from 1950-1995 Chinese medical X-ray workers' cohort study and meta-analysis. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:90-97. [PMID: 39034957 PMCID: PMC11256586 DOI: 10.1016/j.jncc.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022] Open
Abstract
Background It has been well-established that acute radiation exposures increase the risk of leukemia. However, it is still unknown whether these leukemia risk estimates could be extrapolated to occupational populations who receive repeated low-dose radiation exposure. The purpose of this study was to estimate quantified associations between low-dose radiation exposures and leukemia. Methods The Chinese medical X-ray worker study (CMXW) included 27,011 medical X-ray workers employed at major hospitals in 24 provinces in China from 1950 to 1980, and a control population of 25,782 physicians matched by hospital, who were unexposed to X-ray equipment. Poisson regression models were used to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for the incidence of leukemia associated with cumulative doses. A meta-analysis of the published literature on low-dose occupational radiation exposure and leukemia risk was also conducted. Results The incidence rates of leukemia in X-ray workers and the control group were 6.70 and 3.39 per 100,000 person-years, respectively. Among X-ray workers, the average cumulative red bone marrow dose was 0.046 Gy. We found a positive relationship between 2-year lagged cumulative red bone marrow dose and risk of leukemia excluding chronic lymphocytic leukemia (CLL) (ERR = 0.66 per 100 mGy, 90% CI: 0.09, 1.53; EAR = 0.29 per 104 PY-100 mGy, 90% CI: 0.07, 0.56). The excess risk was largely driven by myeloid leukemia (ERR = 1.06 per 100 mGy, 90% CI: 0.22, 2.51). Based on the meta-analysis, the pooled ERR at 100 mGy was 0.19 (95% CI: 0.08, 0.31). Conclusion This study provides strong evidence of a positive and linear doseresponse relationship between cumulative red bone marrow dose and the incidence of non-CLL leukemia.
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Affiliation(s)
- Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Jinhan Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yan Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Chang Xu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yang Liu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Liqing Du
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Qin Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Kaihua Ji
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ningning He
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Manman Zhang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Huijuan Song
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xiaohui Sun
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Jixian Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Amy Berrington de Gonzalez
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Kaijun Niu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qiang Liu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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Abraham RE, Alghazwi M, Liang Q, Zhang W. Advances on marine-derived natural radioprotection compounds: historic development and future perspective. MARINE LIFE SCIENCE & TECHNOLOGY 2021; 3:474-487. [PMID: 37073261 PMCID: PMC10077276 DOI: 10.1007/s42995-021-00095-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/23/2020] [Indexed: 05/03/2023]
Abstract
Natural extracts and compounds from marine resources have gained intensive scientific and industry attention for radioprotective activities in the past ten years. However, the marine-derived radioprotectants have been studied against UV-rays, gamma (γ)-rays and X-rays for more than 30 years. This review aims to identify key marine-derived extracts/compounds and their modes of action studied for radioprotective activities from 1986 to 2019. A comprehensive survey was conducted to establish the trend in terms of the publications each year and the countries of origin. A total of 40 extracts and 34 natural compounds showing radioprotective activities against UV-rays, gamma (γ)-rays and X-rays were identified from a range of marine plants and animals. These extracts and compounds are broadly categorized into polysaccharides, phlorotannins, carotenoids and mycosporine-like amino acids (MAAs). Macroalgae and microalgae were found to be the dominant sources of polysaccharides, phlorotannins and carotenoids. MAAs were mainly identified in algae, sponges, sea cucumber and corals that showed significant UV-absorbing activities. A number of radioprotective mechanisms were shown by these compounds, predominantly free radicals scavenging, inhibition of apoptosis, UV-ray absorption and DNA damage-repair signaling pathways. While these bio-discoveries warrant further investigation and development of radioprotective therapeutics, however, the lack of clinical studies is a major obstacle to be tackled in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s42995-021-00095-x.
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Affiliation(s)
- Reinu E. Abraham
- Centre for Marine Bioproducts Development, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042 Australia
| | - Mousa Alghazwi
- Centre for Marine Bioproducts Development, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042 Australia
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Qi Liang
- Centre for Marine Bioproducts Development, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042 Australia
- Shanxi University of Traditional Chinese Medicine, Taiyuan, 030619 China
| | - Wei Zhang
- Centre for Marine Bioproducts Development, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042 Australia
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15
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Gbetchedji AA, Mansouri I, Hounsossou HC, Houndetoungan GD, Gbaguidi BA, Haddy N, Medehouenou TCM, Avocefohoun AS, Takou DS, Rubino C, Biaou O, Medenou D, de Vathaire F, Amoussou-Guenou KM, Allodji RS. Experimental Assessment of Workplace Radiation Exposure in Diagnostic X-ray Medical Imaging Centres in Benin from 2019 to 2020. Ann Work Expo Health 2021; 65:988-997. [PMID: 34254985 DOI: 10.1093/annweh/wxab046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/15/2022] Open
Abstract
The ease of prescribing radiological examinations has prompted an expansion in radiological procedures and, consequently, an increase of occupational dose to medical imaging workers. However, little is known about radiation exposure in the workplace of medical radiology professionals in many countries, and in Benin particularly. The purpose of this study was to assess ambient radiation doses in diagnostic X-ray medical facilities in Benin and to observe whether exposure levels are below reference levels. A total of 72 public and private medical imaging centres participated in a cross-sectional study carried out from June 2019 to February 2020 in Benin. These centres had 59 X-ray, four chest and six computed tomography (CT) scan rooms. A calibrated radiameter able to measure short, pulsed or continuous X fields and gamma/beta (50 nSv to 10 Sv) was used to measure exposure levels in these functional rooms. Scattered X-ray doses and exposure time from radiological examinations both behind the lead glass of the control area to assess the levels of exposure of professionals and outside of the examination room to evaluate the level of exposure of the public (including non-exposed workers) have been provided. Equivalent doses estimated per hour were compared with the reference levels of 7.50 and 0.05 µSv per hour for workers and the public, respectively. At the control area, the mean/median (min-max) equivalent doses were 0.09/0.07 (0.00-0.21), 2.39/0.13 (0.00-75.67), and 228.39/28.65 (0.39-869.75) µSv per hour for the chest, X-ray, and CT-scan rooms, respectively. Among 69 examination rooms, 13.04% of the equivalent dose estimated in the workplace behind the lead glass was greater than 7.50 µSv per hour; 65 out of 69 examination rooms showed that 40.00% of the equivalent dose estimated behind the doors was greater than 0.05 µSv per hour. These results demonstrated that current controls, including leaded glass separating the control panel and leaded doors between the examination room and the corridor, are inadequate to limit radiation exposures. The controls must be upgraded and a dosimetry program should be implemented to monitor exposures of employees, patients, and visitors.
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Affiliation(s)
- Arnaud A Gbetchedji
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France.,École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Imene Mansouri
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France
| | - Hubert C Hounsossou
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Gilles D Houndetoungan
- Faculté des Sciences de la Santé, 01 P.O. Box 188, Campus Universitaire Champ de Foire, Cotonou, Benin
| | - Bertin A Gbaguidi
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Nadia Haddy
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France
| | - Thierry C M Medehouenou
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Alphonse S Avocefohoun
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Daniel S Takou
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Carole Rubino
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France
| | - Olivier Biaou
- Faculté des Sciences de la Santé, 01 P.O. Box 188, Campus Universitaire Champ de Foire, Cotonou, Benin
| | - Daton Medenou
- École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Florent de Vathaire
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France
| | - Kuassi M Amoussou-Guenou
- Faculté des Sciences de la Santé, 01 P.O. Box 188, Campus Universitaire Champ de Foire, Cotonou, Benin
| | - Rodrigue S Allodji
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP-U1018, Radiation Epidemiology Team, 94807, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, F-94805 Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, F-94805 Villejuif, France.,École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
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16
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Lee WJ, Ko S, Bang YJ, Choe SA, Choi Y, Preston DL. Occupational radiation exposure and cancer incidence in a cohort of diagnostic medical radiation workers in South Korea. Occup Environ Med 2021; 78:876-883. [PMID: 34039756 PMCID: PMC8606456 DOI: 10.1136/oemed-2021-107452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022]
Abstract
Objectives We investigated the association between protracted low-dose ionising radiation and the risk of cancer in medical radiation workers, the largest group of workers with occupational radiation exposures. Methods Data of all South Korean diagnostic medical radiation workers enrolled at the National Dose Registry during 1996–2011 were merged with the death and cancer incidence data until 31 December 2017. SIRs, relative risks and excess relative risks (ERRs) for cancer were calculated to quantify the radiation dose–response relationship using Poisson regression models. Results A total of 3392 first primary cancer cases were identified among 93 920 diagnostic medical radiation workers. The mean cumulative badge dose in the cohort was 7.20 mSv. The ERRs for solid cancer with a 5-year lag and haematopoietic cancers with a 2-year lag for all workers were 0.15 per 100 mGy (95% CI −0.20 to 0.51) and 0.09 per 100 mGy (95% CI −2.02 to 2.20), respectively. The ERRs for cancers did not significantly vary by job title, different lag years or after excluding thyroid and lung cancers. Sensitivity analyses restricted to workers employed for at least 1 year, or who were employed in or after 1996, or who had exposure to a cumulative badge dose of 1 mSv or more showed similar results. Conclusions Occupational radiation doses were not significantly associated with cancer incidence among South Korean diagnostic medical radiation workers. However, cautious interpretation of ERRs is needed due to the limitations of short follow-up and low cumulative radiation doses.
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Affiliation(s)
- Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ye Jin Bang
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seung-Ah Choe
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeongchull Choi
- Seoul Workers' Health Center, Ewha Womans University, Seoul, South Korea
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park IW, Kim SJ, Shin D, Shim SR, Chang HK, Kim CH. Radiation exposure to the urology surgeon during retrograde intrarenal surgery. PLoS One 2021; 16:e0247833. [PMID: 33720938 PMCID: PMC7959394 DOI: 10.1371/journal.pone.0247833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/12/2021] [Indexed: 11/19/2022] Open
Abstract
Retrograde intrarenal surgery is a common procedure that carries a risk of radiation exposure for urologists. This study aimed to measure the amount of radiation that urologists are exposed to during surgery, and to estimate how many procedures can be safely performed by one urologist per year. Variables that affect radiation exposure were also identified. Radiation exposure doses were measured for the eye, neck, chest, arms, and hands of a urologist who performed 226 retrograde intrarenal surgeries. To determine how many procedures could be safely performed per year, the Annual Permissible Occupational Exposure Radiation Dose Guidelines of the National Council on Radiation Protection and Measurements were consulted. Correlations between radiation exposure dose and the patient's age, sex, body mass index, stone number/burden/laterality/location/Hounsfield unit, and their renal calculi were calculated. The mean surgery and fluoroscopy durations were 83.2 and 5.13 min; the mean tube voltage and current were 68.88 kV and 2.48 mA, respectively. Cumulative radiation doses for the eye, neck, chest, right upper arm, left hand, and right hand were 65.53, 69.95, 131.79, 124.43, 165.66, and 126.64 mSv, respectively. Radiation reduction rates for lead collars and aprons were 97% and 98%, respectively. If the urologists wear only radiation shields and lead apron but do not wear safety glasses during RIRS, the recommended by the ICRP publication 103 is taken into consideration, our results showed that 517 RIRS can be performed per year safely. However, if no protective measures are taken, this number decreases to only 85 RIRS per year. At all measurement sites, significant correlations were observed between the radiation exposure dose and stone numbers and Hounsfield unit values. In conclusion, it is imperative that urologists wear protective gear. Greater effort should be made to reduce radiation exposure when renal calculi have a large number of stones or large Hounsfield unit values.
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Affiliation(s)
- Il woo park
- Department of Urology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Su Jin Kim
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Dongseong Shin
- Department of Pharmacology, Gachon University College of Medicine, Incheon, Korea
- Clinical Trials Center, Gachon University Gil Medical Center, Incheon, Korea
| | - Sung Ryul Shim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun Kyung Chang
- Department of Urology, Catholic Kwandong University, International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Chang Hee Kim
- Department of Urology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Henning MAS, Jemec GB, Ibler KS. Occupational Skin Disease in Physicians: A Review of the Literature. Ann Work Expo Health 2021; 65:11-25. [PMID: 33009561 DOI: 10.1093/annweh/wxaa091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/29/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Occupational skin disease (OSD) arises from work-related activity. However, there is a paucity of literature on OSD in physicians. The aim of the this review was therefore to examine and summarize what types of symptomatic OSD physicians experience. METHODS We conducted a systematic literature search on Cochrane Library, Embase, and Pubmed. RESULTS Contact dermatitis from formaldehyde and glutaraldehyde were found in 11.5 and 13.5% of cases, respectively. In total 2.4-14.9% had latex allergy. The reported standardized incidence ratio of squamous cell carcinoma and melanoma was up to 2.15 [95% confidence interval (CI) 1.57-1.95] and 3.2 (95% CI 1.38-6.31). Transmission of human papilloma virus (HPV) particles during carbon dioxide laser wart ablation were found in 70% of samples collected from protective gloves and in 52% of samples from vapors. CONCLUSIONS The most frequently reported OSD in physicians is contact dermatitis from allergens in disinfectants and rubber gloves. There is also a risk of cutaneous reactions to latex. The incidence of skin cancer was higher in physicians than in the general population, and the reason for this remains unexplained and potentially biased. There are no reports of transmission of patient HPV to surgeons during wart ablation, possibly because of proper use of protective equipment.
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Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
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Shahid S, Masood K, Khan AW. Prediction of impacts on liver enzymes from the exposure of low-dose medical radiations through artificial intelligence algorithms. Rev Assoc Med Bras (1992) 2021; 67:248-259. [PMID: 34406249 DOI: 10.1590/1806-9282.67.02.20200653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed to develop artificial intelligence and machine learning-based models to predict alterations in liver enzymes from the exposure of low annual average effective doses in radiology and nuclear medicine personnel of Institute of Nuclear Medicine and Oncology Hospital. METHODS Ninety workers from the Radiology and Nuclear Medicine departments were included. A high-capacity thermoluminescent was used for annual average effective radiation dose measurements. The liver function tests were conducted for all subjects and controls. Three supervised learning models (multilayer precentron; logistic regression; and random forest) were applied and cross-validated to predict any alteration in liver enzymes. The t-test was applied to see if subjects and controls were significantly different in liver function tests. RESULTS The annual average effective doses were in the range of 0.07-1.15 mSv. Alanine transaminase was 50% high and aspartate transaminase was 20% high in radiation workers. There existed a significant difference (p=0.0008) in Alanine-aminotransferase between radiation-exposed and radiation-unexposed workers. Random forest model achieved 90-96.6% accuracies in Alanine-aminotransferase and Aspartate-aminotransferase predictions. The second best classifier model was the Multilayer perceptron (65.5-80% accuracies). CONCLUSION As there is a need of regular monitoring of hepatic function in radiation-exposed people, our artificial intelligence-based predicting model random forest is proved accurate in prediagnosing alterations in liver enzymes.
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Affiliation(s)
- Saman Shahid
- National University of Computer and Emerging Sciences, Foundation for the Advancement of Science and Technology, Department of Sciences & Humanities - Lahore, Pakistan
| | - Khalid Masood
- Institute of Nuclear Medicine and Oncology Lahore, Department of Medical Physics - Lahore, Pakistan
| | - Abdul Waheed Khan
- Institute of Nuclear Medicine and Oncology Lahore, Department of Medical Physics - Lahore, Pakistan
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20
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Gbetchedji AA, Houndetoungan GD, Hounsossou HC, Journy N, Haddy N, Rubino C, Biaou O, Medenou D, Amoussou-Guenou KM, de Vathaire F, Allodji RS. A systematic review of occupational radiation individual dose monitoring among healthcare workers exposed in Africa. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R141-R150. [PMID: 32640436 DOI: 10.1088/1361-6498/aba402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/08/2020] [Indexed: 06/11/2023]
Abstract
Dosimetric monitoring is useful to limit exposures to ionising radiation in medical occupational settings, and reduce subsequent health risks. Scientific literatures, such as the UNSCEAR report 2017 and International Atomic Energy Agency Report 2014b, updated information on this subject; however, few African works have been found. This is the reason why we undertook this study, which summarises existing information on monitoring external radiation exposure doses for the whole body, using data from medical workers on this continent. Using standard terms and combining different keyword searches for radiation dose monitoring among radiology healthcare workers in Africa, from the titles, abstracts, and full texts, we found 3139 articles in the PubMed/MEDLINE, Google Scholar and INIS databases. Two reviewers screened the retrieved publications based on predefined eligibility criteria to identify relevant studies, extract key information from each, and summarise the data in table form. A total of 20 potentially relevant articles were identified. Among these 20 articles, 15 reported the overall average annual effective dose. Studies included in this systematic review represent an inventory of the radiation protection of medical workers in various African countries, with a focus on the monitoring of occupational radiation exposure. The size of studied populations ranged between 81 and 5152 occupational exposed workers. The mean annual effective doses ranged from 0.44 to 8.20 mSv in all specialities of medical sectors, while diagnostic radiology ranged from 0.07 to 4.37 mSv. For the nuclear medicine and radiotherapy from medical groups, the mean annual effective dose varied between 0.56 and 6.30 mSv. Industrial and research/teaching sectors data varied between 0.38 to 19.40 mSv. In conclusion, more studies implemented on dosimetric monitoring in Africa are needed to get a real picture of occupational exposure in the continent.
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Affiliation(s)
- Arnaud A Gbetchedji
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, P.O. Box 188, Cotonou, Bénin
- Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Gilles D Houndetoungan
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, P.O. Box 188, Cotonou, Bénin
| | - Hubert C Hounsossou
- Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | - Neige Journy
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
| | - Nadia Haddy
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
| | - Carole Rubino
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
| | - Olivier Biaou
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, P.O. Box 188, Cotonou, Bénin
| | - Daton Medenou
- Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
| | | | - Florent de Vathaire
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
| | - Rodrigue S Allodji
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe Cancer and Radiation, CESP, Villejuif 94807, France
- INSERM, CESP, Cancer and Radiation Team, Villejuif 94805, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, Villejuif 94805, France
- Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin
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21
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Chartier H, Fassier P, Leuraud K, Jacob S, Baudin C, Laurier D, Bernier MO. Occupational low-dose irradiation and cancer risk among medical radiation workers. Occup Med (Lond) 2020; 70:476-484. [DOI: 10.1093/occmed/kqaa130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.
Aims
This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.
Methods
Epidemiological studies on health professionals exposed to IR published from 1975 to 2019 were reviewed. Strength of evidence was assessed according to the modified Royal College of General Practitioners three-star system.
Results
Among the 16 epidemiological studies focusing on cancers from 11 cohorts among medical staff exposed to radiation, higher risks of cancer were observed for pre-1950 exposure and for medical workers who performed fluoroscopically guided interventional procedures or radionuclides procedures compared to those who did not. However, strength of evidence supporting the associations remains moderate as several methodological limits including the lack of dosimetry data, lifestyle factors and recent updates may obscure the link between medical occupational exposure and cancer occurrence.
Conclusions
Excess risk of cancer is suspected for high and former exposures. The more highly exposed professions, i.e. interventional physicians and nuclear medicine workers, should be monitored carefully. Collaborative projects aiming to increase the quantity and quality of information of the studied populations would be a key point
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Affiliation(s)
- H Chartier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
- Percy Hospital, Radiological Protection Service of the Armed Forces (SPRA), Clamart, France
| | - P Fassier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - K Leuraud
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - S Jacob
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - C Baudin
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - D Laurier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - M-O Bernier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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Impact of Surgical Experience on Radiation Exposure during Retrograde Intrarenal Surgery: A Propensity-Score Matching Analysis. Eur Urol Focus 2020; 6:157-163. [PMID: 30219708 DOI: 10.1016/j.euf.2018.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/03/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The impact of surgical experience on radiation exposure (RE) during endourological procedures has been poorly investigated. OBJECTIVE To assess the impact of surgical experience on fluoroscopy time (FT) and RE during retrograde intrarenal surgery (RIRS). DESIGN, SETTING, AND PARTICIPANTS The study included 140 patients who underwent RIRS performed either by a senior surgeon (expertise of >100 RIRSs) (group A) or by two junior residents (expertise of <15 RIRSs) (group B) between January 2016 and May 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We tested the hypothesis that surgical experience had a limited impact on RE during RIRS. To adjust for potential baseline confounders, propensity-score matching was performed. Descriptive statistics and linear regression models tested the association between clinical variables and FT and patients' effective doses. RESULTS AND LIMITATIONS There was no significant difference between the two groups for baseline, intraoperative, and postoperative characteristics. Overall FT (p=0.97) and effective dose (p=0.79) did not differ between groups. A statistically significant association was found between male sex (all p<0.03), stone burden (all p<0.001), operative time (all p<0.003), and postoperative double-J placement (all p<0.02) with both FT and effective dose. Linear multivariable analysis revealed that body mass index was significantly associated with effective dose (p=0.002). Similarly, longer operative time (all p<0.03) and double-J placement (all p<0.04) were significantly associated with increased FT and effective dose. CONCLUSIONS Surgical experience has a limited impact on FT and RE during RIRS. Longer operative time and double-J placement were associated with increased FT and effective dose. PATIENT SUMMARY In this study, we assessed whether surgical experience affects fluoroscopy time and patient's effective dose during retrograde intrarenal surgery (RIRS). We found that radiation exposure (RE) was not affected by surgeon's experience and that the standardisation of the surgical technique at the beginning of the learning curve of young surgeons may represent the key factor in reducing RE during RIRS.
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Sadakane A, French B, Brenner AV, Preston DL, Sugiyama H, Grant EJ, Sakata R, Utada M, Cahoon EK, Mabuchi K, Ozasa K. Radiation and Risk of Liver, Biliary Tract, and Pancreatic Cancers among Atomic Bomb Survivors in Hiroshima and Nagasaki: 1958-2009. Radiat Res 2019; 192:299-310. [PMID: 31291162 PMCID: PMC10273724 DOI: 10.1667/rr15341.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The Life Span Study (LSS) of atomic bomb survivors has consistently demonstrated significant excess radiation-related risks of liver cancer since the first cancer incidence report. Here, we present updated information on radiation risks of liver, biliary tract and pancreatic cancers based on 11 additional years of follow-up since the last report, from 1958 to 2009. The current analyses used improved individual radiation doses and accounted for the effects of alcohol consumption, smoking and body mass index. The study participants included 105,444 LSS participants with known individual radiation dose and no known history of cancer at the start of follow-up. Cases were the first primary incident cancers of the liver (including intrahepatic bile duct), biliary tract (gallbladder and other and unspecified parts of biliary tract) or pancreas identified through linkage with population-based cancer registries in Hiroshima and Nagasaki. Poisson regression methods were used to estimate excess relative risks (ERRs) and excess absolute risks (EARs) associated with DS02R1 doses for liver (liver and biliary tract cancers) or pancreas (pancreatic cancer). We identified 2,016 incident liver cancer cases during the follow-up period. Radiation dose was significantly associated with liver cancer risk (ERR per Gy: 0.53, 95% CI: 0.23 to 0.89; EAR per 10,000 person-year Gy: 5.32, 95% CI: 2.49 to 8.51). There was no evidence for curvature in the radiation dose response (P=0.344). ERRs by age-at-exposure categories were significantly increased among those who were exposed at 0-9, 10-19 and 20-29 years, but not significantly increased after age 30 years, although there was no statistical evidence of heterogeneity in these ERRs (P = 0.378). The radiation ERRs were not affected by adjustment for smoking, alcohol consumption or body mass index. As in previously reported studies, radiation dose was not associated with risk of biliary tract cancer (ERR per Gy: -0.02, 95% CI: -0.25 to 0.30). Radiation dose was associated with a nonsignificant increase in pancreatic cancer risk (ERR per Gy: 0.38, 95% CI: <0 to 0.83). The increased risk was statistically significant among women (ERR per Gy: 0.70, 95% CI: 0.12 to 1.45), but not among men.
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Affiliation(s)
- Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Benjamin French
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Alina V. Brenner
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | | | - Hiromi Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Eric J. Grant
- Associate Chief of Research, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Elizabeth K. Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
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Harris AM, Loomis J, Hopkins M, Bylund J. Assessment of Radiation Safety Knowledge Among Urology Residents in the United States. J Endourol 2019; 33:492-497. [PMID: 30997835 PMCID: PMC6588117 DOI: 10.1089/end.2019.0133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Urologists are increasingly exposed to fluoroscopy, which can cause cellular damage. Appropriate awareness and safety precautions concerning fluoroscopy are necessary and likely should be a focus during training. We sought to assess radiation safety knowledge among Urology residents in the United States. Methods: A 19-question survey was constructed to assess radiation safety training, knowledge, behavior, and attitudes. The survey was sent through REDCap™ (Research Electronic Data Capture) to all Urology program directors and coordinators in the United States with a request to distribute to their residents. The survey was closed after 3 weeks. Results: One hundred thirty-six urology trainees responded during the study period. Thirteen percent learned fluoroscopic radiation safety formally, 46% informally, 35% both informally and formally, and 6% no education. Forty-six percent reported radiation safety being part of their curriculum. When asked about directional X-ray travel and exposure, only 54% answered correctly. Regarding conditions related to radiation exposure, 94% believe infertility is potentially related, 83% cataracts, 93% leukemia and lymphoma, 57% central nervous system tumors, 77% birth defects, and 4% diabetes. Regarding protection, 9% wear lead-lined glasses, 30% dosimeters, 99% thyroid shields, 0% lead gloves, 97% lead apron, 26% lead shield, and 0% nothing. Regarding fluoroscopy machine settings, 7% knew the machine used was set to continuous, 73% pulse, and 21% were unsure. Sixty-six percent had awareness of the directional travel of the machine routinely used. Regarding safety techniques, 99% knew decreasing time and 100% knew wearing protective materials decrease exposure. However, when asked about distance and exposure, 55% answered incorrectly. Most respondents believe radiation safety is important (89%) and desire more formal education (64%). Conclusions: Trainees lack sufficient knowledge in several key areas regarding radiation safety. Formal education may be considered during training and is desired by trainees. This education is likely needed to ensure trainees learn methods to keep them safe during their career.
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Affiliation(s)
- Andrew M. Harris
- Department of Urology, University of Kentucky Medical Center, Lexington, Kentucky
| | - John Loomis
- Department of Urology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Marilyn Hopkins
- Department of Urology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Jason Bylund
- Department of Urology, University of Kentucky Medical Center, Lexington, Kentucky
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Lee WJ, Preston DL, Cha ES, Ko S, Lim H. Thyroid cancer risks among medical radiation workers in South Korea, 1996-2015. Environ Health 2019; 18:19. [PMID: 30857541 PMCID: PMC6413450 DOI: 10.1186/s12940-019-0460-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Thyroid cancer rates, especially among children, are known to be increased by radiation exposure. However, little is known about the impact of chronic low-dose radiation exposure on thyroid cancer risk in adulthood. This study examined radiation effects on thyroid cancer rates as well as an overall evaluation of thyroid cancer risk among medical radiation workers. METHODS Data on all diagnostic medical radiation workers enrolled in the national dosimetry registry between 1996 and 2011 were linked with the cancer registry data through 2015. Standardized incidence ratios (SIRs) were used to compare the observed cancer incidence rates in this population to those for the general population while internal comparisons were used to estimate relative risks (RRs) for occupational history and excess relative risks (ERRs) were used to quantify the radiation dose-response relationship. RESULTS Overall, 827 thyroid cancer cases were reported among 93,922 medical radiation workers. Thyroid cancer SIRs were significantly higher than expected for both men (SIR 1.72, 95% confidence interval [CI] 1.53 to 1.91) and women (SIR 1.18, 95% CI 1.08 to 1.28). However, RRs for thyroid cancer by job title and duration of employment showed no particular pattern among diagnostic medical radiation workers. There were no indications of a significant dose effect on thyroid cancer rates for either men (ERR/100 mGy 0.07, 95% CI -0.38 to 0.53) or women (ERR/100 mGy -0.13, 95% CI -0.49 to 0.23). The findings were similar for different job titles or when limited to workers employed for at least one year. CONCLUSIONS While thyroid cancer incidence rates among Korean medical radiation workers were somewhat higher than those in the general population, there was no significant evidence that this increase was associated with occupational radiation dose. Additional follow-up together with consideration of other risk factors should provide useful information on thyroid cancer rates in this cohort.
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Affiliation(s)
- Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | | | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hyeyeun Lim
- Environmental Health Center, Asan Medical Center, Seoul, South Korea
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Abstract
Objective To analyze the incidence and mortality rates of thyroid cancer (TC) in China from 2008 to 2012. Methods Incident and death cases of TC were retrieved from the National Central Cancer Registry (NCCR) database collecting from 135 cancer registries in China during 2008-2012. The crude incidence and mortality rates of TC were calculated by area (urban/rural), region (eastern, middle, western), gender and age group (0, 1-4, 5-9, …, 85+). China census in 2000 and world Segi's population were applied for age-standardized rates. Joinpoint (Version 4.6.0.0) model was used for time-trend analysis. Results The crude incidence rate of TC was 7.56/100,000 which ranked the seventh in overall cancers. The age-standardized incidence rates by China population (ASIRC) and by World population (ASIRW) were 6.25/100,000 and 5.52/100,000, respectively. The crude mortality of TC in China was 0.52/100,000. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 0.34/100,000 and 0.32/100,000, respectively. Incidence and mortality rates of TC were higher in females than in males and higher in urban areas than in rural areas. Eastern areas had the highest incidence followed by middle and western areas. TC incidence increased dramatically after age of 15 years, then peaked at 14.08/100,000 in the group of 50-54 years and finally decreased sharply after 55 years old. TC mortality increased with age in population, reaching the peak of 5.09/100,000 in sub-population aged 85 years or older. TC incidence increased by 4.73 times from 2.40/100,000 in 2003 to 13.75/100,000 in 2012 with an average annual increase of 20%, while TC mortality only increased slightly around 0.32/100,000 from 0.26/100,000 to 0.36/100,000. Conclusions Appropriate targeted prevention, early detection and treatment programs can be carried out to curb the rapid growth trend of TC and control the disease burden.
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Affiliation(s)
- Lingbin Du
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Runhua Li
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Minghua Ge
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Youqing Wang
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Huizhang Li
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Wanqing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
| | - Jie He
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
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Imaoka T, Nishimura M, Daino K, Hosoki A, Takabatake M, Nishimura Y, Kokubo T, Morioka T, Doi K, Shimada Y, Kakinuma S. Prominent Dose-Rate Effect and Its Age Dependence of Rat Mammary Carcinogenesis Induced by Continuous Gamma-Ray Exposure. Radiat Res 2018; 191:245-254. [PMID: 30543491 DOI: 10.1667/rr15094.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although the risk of breast cancer after high-dose-rate irradiation has been firmly established, however, the risk incurred for low-dose-rate irradiation is not well understood. Here we provide experimental evidence for dose rate and age dependencies induced by continuous γ-ray irradiation on mammary carcinogenesis. Female rats received continuous whole-body irradiation at one of the following time points: at 7 weeks of age (denoted adults) at a dose rate of 3-60 mGy/h (4 Gy total); or at either 3 weeks (denoted juveniles) or 7 weeks of age at a dose rate of 6 mGy/h (1-8 Gy total). Additional rats were acutely irradiated at 13 weeks of age at a dose rate of 30 Gy/h (0.5-4 Gy total). We observed the incidence of mammary tumors by weekly palpation until they were 90 weeks old and after pathological inspection upon autopsy. The tumor incidence rate for each group was characterized by Cox regression analysis. When adult rats were irradiated at 60 mGy/h for a total of 4 Gy, their hazard ratio for mammary carcinoma significantly increased relative to nonirradiated controls; however, for adult rats irradiated at 3-24 mGy/h, even though they also received a total of 4 Gy, their hazard ratio for carcinoma incidence did not significantly increase. A larger increase in the incidence rate of carcinoma per dose was found for the juveniles than for the adults irradiated at 6 mGy/h, whereas age did not influence the effect of acute irradiation at 30 Gy/h; a threshold-like dose response was observed for irradiation at 6 mGy/h (threshold, ∼2.5 and ∼4 Gy for juveniles and adults, respectively). Regarding benign tumors of the mammary gland, a significant increase in their incidence was observed for irradiation down to 6 mGy/h, but not at 3 mGy/h and there was no evidence of age-dependent induction. Thus, induction of female rat mammary carcinogenesis by continuous γ-ray exposure was age dependent and drastically increased for adult rats that received between 24 and 60 mGy/h irradiation.
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Affiliation(s)
- Tatsuhiko Imaoka
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan.,d QST Advanced Study Laboratory, QST, Chiba, Japan.,e Tokyo Metropolitan University, Tokyo, Japan
| | - Mayumi Nishimura
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Kazuhiro Daino
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Ayaka Hosoki
- f Fukushima Project Headquarters, NIRS, Chiba, Japan
| | - Masaru Takabatake
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan.,e Tokyo Metropolitan University, Tokyo, Japan
| | - Yukiko Nishimura
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Toshiaki Kokubo
- b Department of Engineering and Safety, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Takamitsu Morioka
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Kazutaka Doi
- c Center for Radiation Protection Knowledge, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Yoshiya Shimada
- e Tokyo Metropolitan University, Tokyo, Japan.,g Executive Director, QST, Chiba, Japan
| | - Shizuko Kakinuma
- a Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
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Bernier MO, Doody MM, Van Dyke ME, Villoing D, Alexander BH, Linet MS, Kitahara CM. Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures. Occup Environ Med 2018; 75:533-561. [PMID: 29720482 PMCID: PMC6051924 DOI: 10.1136/oemed-2017-104559] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/19/2018] [Accepted: 04/03/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. METHODS From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. RESULTS During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. CONCLUSION Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.
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Affiliation(s)
- Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Daphnee Villoing
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
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Radiation Exposure to the Urologist Using an Overcouch Radiation Source Compared With an Undercouch Radiation Source in Contemporary Urology Practice. Urology 2018; 114:45-48. [DOI: 10.1016/j.urology.2017.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/06/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022]
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Kim J, Cha ES, Choi Y, Lee WJ. WORK PROCEDURES AND RADIATION EXPOSURE AMONG RADIOLOGIC TECHNOLOGISTS IN SOUTH KOREA. RADIATION PROTECTION DOSIMETRY 2018; 178:345-353. [PMID: 28981862 DOI: 10.1093/rpd/ncx120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
This study explored their work characteristics and safety compliance to identify primary factors influencing high occupational radiation exposure among radiologic technologists. A total of 12 387 radiologic technologists were surveyed from 2012 to 2013 in South Korea. Survey data for demographics and work-related characteristics were linked with the National Dose Registry. Multiple regression analysis was used and '% Excess Risk Explained' was calculated to illustrate the degree to which given risk factors explained the relationship of work procedures and radiation exposure. Characteristics of radiologic technologists exposed to higher radiation doses were male, aged <30, working at a general hospital or hospital, and frequently performing routine diagnostic X-ray, CT, portable X-ray and C-arm. Not being completely separated from patients and wearing lead apron was positively associated with higher radiation exposure. Type of facility and safety compliance were the main risk factors for high radiation exposure in performing diagnostic radiologic procedures.
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Affiliation(s)
- Jaeyoung Kim
- Department of Preventive Medicine, Keimyung University College of Medicine, Daegu, Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yeongchull Choi
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Kim BH, Kwon YJ, Ju YS, Kim BK, Lee HS, Lee SG, Chung YK. The work-relatedness at a case of acute lymphoblastic leukemia in a radiation oncologist. Ann Occup Environ Med 2017; 29:28. [PMID: 28670458 PMCID: PMC5485618 DOI: 10.1186/s40557-017-0186-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/15/2017] [Indexed: 12/04/2022] Open
Abstract
Background Clinicians who perform radiation therapy (RT) are exposed to radiation, which may negatively affect their health. The present study reports a case of acute lymphoblastic leukemia in a healthcare provider who was exposed to radiation at work; we also present a literature review of this topic. Case presentation A 45-year-old patient, who had been a radiation oncologist and had been exposed to radiation while performing brachytherapy 10 years ago, complained of chest pain and was suspected of having leukemia based on the results of a blood test in an outpatient clinic. He was diagnosed with acute lymphoblastic leukemia, and subsequently underwent chemotherapy. However, the case died during treatment. Through epidemiological investigation, it was found that the case’s cumulative exposure dose based on personal exposure and spatial dose measured during the work period was in the range of 6.08–12.15 mSv. Conclusions Based on the following considerations, acute lymphoblastic leukemia was highly correlated with the level of radiation to which the case was exposed while performing brachytherapy on patients with cancer. Firstly, the latent period of acute lymphoblastic leukemia in the case closely matched the latency time reported in previous published studies (5–10 years). In addition, numerous studies have reported significantly higher relative risks of cancer among clinicians who perform RT compared with the general population. The case was also atypically exposed to radiation through his hands, despite wearing protective equipment. Lastly, the case’s coworkers were also found to have been exposed to high levels of radiation. Investigation into the influence of radiation exposure through atypical routes during RT on the health of clinicians is recommended.
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Affiliation(s)
- Bong Hyun Kim
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
| | - Young-Jun Kwon
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
| | - Young-Su Ju
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
| | - Bong Kyu Kim
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
| | - Hyun Seok Lee
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
| | - Sang-Gil Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan city, Republic of Korea
| | - Yun Kyung Chung
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Dongangu 772, Anyang city, Republic of Korea
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Assessing liver proteins and enzymes of medical workers exposed to ionizing radiation (IR). Clin Exp Med 2017; 18:89-99. [PMID: 28493150 DOI: 10.1007/s10238-017-0462-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/02/2017] [Indexed: 12/20/2022]
Abstract
The cross-sectional study was conducted to examine hepatic function via liver enzymes/proteins assessments, along with the estimation of an inflammatory response from C-reactive protein (CRP)-which is a liver-synthesized protein. The liver function tests with aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin (BBN), and CRP test were conducted for radiation-exposed workers-REW (n = 32) and radiation-unexposed workers-RUW (n = 21). The annual average effective doses (AAED) were measured from thermoluminescent dosimeter. A t test and bivariate correlation analyses were applied. Only one worker had a high AST value (50 U/L), one worker had a negligible high ALT value (43 U/L) and only one worker had a negligible high bilirubin value (1.3 g/dL). There were normal levels of CRP (up to 6 mg/L) in all individuals. There existed a nonsignificant difference (p < 0.050) between the mean values of liver enzymes and proteins in all exposed and unexposed workers. Nonsignificant weak correlations are reported in liver enzymes/proteins parameters: AST, ALT, ALP, BBN, CRP with the AAED range (whole-body: 0.91-3.39 mSv) during 2011-2015. The normal values of liver enzymes/proteins' (AST, ALT, ALP, BBN, CRP) values may ensure a good hepatic health of radiation-exposed medical workers with AAED range mentioned. We found that low ionizing radiation doses did not alter the liver function test parameters and did not affect the concentration of an inflammatory response protein, i.e., CRP.
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Moosavi SA, Ghanbari Z, Farhadi A, Heshmati F, Shabani S, Mofid-Nakhaei MA. Prompt cytomolecular identification of chromosome aberration in irradiated blood cells. RESEARCH IN MOLECULAR MEDICINE 2017. [DOI: 10.29252/rmm.5.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Kim CH, Kim SJ, Kim MH, Kim KT, Oh JK, Chung KJ, Kim TB, Jung H, Yoon SJ, Kim KH. Are Urologists Performing Semi-rigid Ureteroscopic Lithotripsy Safe From Radiation Exposure? A Guidance to Reduce the Radiation Dose. Urology 2016; 95:54-9. [DOI: 10.1016/j.urology.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
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Awosan KJ, Ibrahim MTO, Saidu SA, Ma’aji SM, Danfulani M, Yunusa EU, Ikhuenbor DB, Ige TA. Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria. J Clin Diagn Res 2016; 10:LC07-12. [PMID: 27656470 PMCID: PMC5028529 DOI: 10.7860/jcdr/2016/20398.8394] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/26/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. AIM To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. MATERIALS AND METHODS A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). RESULTS The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. CONCLUSION This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in-service training and monitoring on radiation safety was suggested.
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Affiliation(s)
- KJ Awosan
- Senior Lecturer, Department of Community Health, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - MTO Ibrahim
- Professor, Department of Community Health, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - SA Saidu
- Associate Professor, Department of Radiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - SM Ma’aji
- Associate Professor, Department of Radiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - M Danfulani
- Senior Lecturer, Department of Radiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - EU Yunusa
- Lecturer, Department of Community Health, Usmanu Danfodiyo University. Sokoto, Nigeria
| | - DB Ikhuenbor
- Chief Medical Laboratory Scientist, Department of Hematology, Usmanu Danfodiyo University, Teaching Hospital, Sokoto, Nigeria
| | - TA Ige
- Chief Consultant Medical Physicist, Department of Medical Physics, National Hospital, Abuja, Nigeria
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Kim HL, Park HJ, Sim YH, Choi EY, Shim KW, Lee SW, Lee HS, Chun H. Cancer Prevalence among Physicians in Korea: A Single Center Study. Korean J Fam Med 2016; 37:91-6. [PMID: 27073607 PMCID: PMC4826997 DOI: 10.4082/kjfm.2016.37.2.91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 08/16/2015] [Accepted: 09/27/2015] [Indexed: 12/02/2022] Open
Abstract
Background There is little research regarding whether working as a physician affects cancer risk. Moreover, there is no research on cancer prevalence among physicians in Korea. This study utilized the Korea National Cancer Incidence Database to determine whether the prevalence of cancer among physicians differs from the prevalence of cancer within the general population. Methods We analyzed the medical records of a representative sample of 382 doctors who underwent a health examination between 2010 and 2013 at a health examination center in a Ewha Womans University Medical Center.Cancer incidence was measured as cases that were eventually diagnosed as cancer according to a biopsy. Results We collected medical records from 382 physicians (mean age, 51.9±8.1 years) and calculated the standardized prevalence ratios compared to the general population. Thirty physicians (9 male and 21 female) were identified as having cancer. Physicians had a significantly higher prevalence of cancer compared to the general population.Cancer prevalence in male physicians was found to be 2.47 times higher than the prevalence expected within the general population (P=0.006). Among female physicians, cancer prevalence was 3.94 times higher than that in the general population (P<0.001). Conclusion This study revealed that physicians had a higher prevalence of cancer compared to the general population in Korea, which suggests that there may be a problem present in the health care of physicians. Changes to the working environment of physicians will be needed to reduce the high prevalence of cancer among physicians.
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Affiliation(s)
- Hye Lin Kim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hae Jin Park
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Yun Hye Sim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Eun Young Choi
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Kyung Won Shim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sang Wha Lee
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hong Soo Lee
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyejin Chun
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
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Wang FR, Fang QQ, Tang WM, Xu XS, Mahapatra T, Mahapatra S, Liu YF, Yu NL, Sun QF. Nested Case-control Study of Occupational Radiation Exposure and Breast and Esophagus Cancer Risk among Medical Diagnostic X Ray Workers in Jiangsu of China. Asian Pac J Cancer Prev 2016; 16:4699-704. [PMID: 26107226 DOI: 10.7314/apjcp.2015.16.11.4699] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Fu-Ru Wang
- Department of Radiation protection, JiangSu Provincial Center for Disease Prevention and Control, Nanjing, China E-mail : ;
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Sun Z, Inskip PD, Wang J, Kwon D, Zhao Y, Zhang L, Wang Q, Fan S. Solid cancer incidence among Chinese medical diagnostic x-ray workers, 1950-1995: Estimation of radiation-related risks. Int J Cancer 2016; 138:2875-83. [PMID: 26860236 DOI: 10.1002/ijc.30036] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 01/22/2016] [Accepted: 01/26/2016] [Indexed: 11/07/2022]
Abstract
The objective of this study was to estimate solid cancer risk attributable to long-term, fractionated occupational exposure to low doses of ionizing radiation. Based on cancer incidence for the period 1950-1995 in a cohort of 27,011 Chinese medical diagnostic X-ray workers and a comparison cohort of 25,782 Chinese physicians who did not use X-ray equipment in their work, we used Poisson regression to fit excess relative risk (ERR) and excess absolute risk (EAR) dose-response models for incidence of all solid cancers combined. Radiation dose reconstruction was based on a previously published method that relied on simulating measurements for multiple X-ray machines, workplaces and working conditions, information about protective measures, including use of lead aprons, and work histories. The resulting model was used to estimate calendar year-specific badge dose calibrated as personal dose equivalent (Sv). To obtain calendar year-specific colon doses (Gy), we applied a standard organ conversion factor. A total of 1,643 cases of solid cancer were identified in 1.45 million person-years of follow-up. In both ERR and EAR models, a statistically significant radiation dose-response relationship was observed for solid cancers as a group. Averaged over both sexes, and using colon dose as the dose metric, the estimated ERR/Gy was 0.87 (95% CI: 0.48, 1.45), and the EAR was 22 per 10(4)PY-Gy (95% CI: 14, 32) at age 50. We obtained estimates of the ERR and EAR of solid cancers per unit dose that are compatible with those derived from other populations chronically exposed to low dose-rate occupational or environmental radiation.
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Affiliation(s)
- Zhijuan Sun
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Peter D Inskip
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Jixian Wang
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Deukwoo Kwon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.,University of Miami School of Medicine Silvestre Comprehensive Cancer Center, Miami, FL
| | - Yongcheng Zhao
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Liangan Zhang
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Qin Wang
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Saijun Fan
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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40
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Li C, Athar M. Ionizing Radiation Exposure and Basal Cell Carcinoma Pathogenesis. Radiat Res 2016; 185:217-28. [PMID: 26930381 DOI: 10.1667/rr4284.s1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This commentary summarizes studies showing risk of basal cell carcinoma (BCC) development in relationship to environmental, occupational and therapeutic exposure to ionizing radiation (IR). BCC, the most common type of human cancer, is driven by the aberrant activation of hedgehog (Hh) signaling. Ptch, a tumor suppressor gene of Hh signaling pathway, and Smoothened play a key role in the development of radiation-induced BCCs in animal models. Epidemiological studies provide evidence that humans exposed to radiation as observed among the long-term, large scale cohorts of atomic bomb survivors, bone marrow transplant recipients, patients with tinea capitis and radiologic workers enhances risk of BCCs. Overall, this risk is higher in Caucasians than other races. People who were exposed early in life develop more BCCs. The enhanced IR correlation with BCC and not other common cutaneous malignancies is intriguing. The mechanism underlying these observations remains undefined. Understanding interactions between radiation-induced signaling pathways and those which drive BCC development may be important in unraveling the mechanism associated with this enhanced risk. Recent studies showed that Vismodegib, a Smoothened inhibitor, is effective in treating radiation-induced BCCs in humans, suggesting that common strategies are required for the intervention of BCCs development irrespective of their etiology.
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Affiliation(s)
- Changzhao Li
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mohammad Athar
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
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Berwick M, Buller DB, Cust A, Gallagher R, Lee TK, Meyskens F, Pandey S, Thomas NE, Veierød MB, Ward S. Melanoma Epidemiology and Prevention. Cancer Treat Res 2016; 167:17-49. [PMID: 26601858 DOI: 10.1007/978-3-319-22539-5_2] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The epidemiology of melanoma is complex, and individual risk depends on sun exposure, host factors, and genetic factors, and in their interactions as well. Sun exposure can be classified as intermittent, chronic, or cumulative (overall) exposure, and each appears to have a different effect on type of melanoma. Other environmental factors, such as chemical exposures-either through occupation, atmosphere, or food-may increase risk for melanoma, and this area warrants further study. Host factors that are well known to be important are the numbers and types of nevi and the skin phenotype. Genetic factors are classified as high-penetrant genes, moderate-risk genes, or low-risk genetic polymorphisms. Subtypes of tumors, such as BRAF-mutated tumors, have different risk factors as well as different therapies. Prevention of melanoma has been attempted using various strategies in specific subpopulations, but to date optimal interventions to reduce incidence have not emerged.
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Affiliation(s)
- Marianne Berwick
- Department of Internal Medicine, University of New Mexico, MSC10-5550, Albuquerque, NM, 87131-0001, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO, 80401, USA.
| | - Anne Cust
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Richard Gallagher
- Cancer Control Research Program, BC Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.
| | - Tim K Lee
- Cancer Control Research Program, BC Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.
| | - Frank Meyskens
- Public Health and Epidemiology, University of California, Irvine, USA.
| | - Shaily Pandey
- Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Nancy E Thomas
- University of North Carolina, 413 Mary Ellen Jones Bldg. CB#7287, Chapel Hill, NC, 275992, USA.
| | - Marit B Veierød
- Department of Biostatistics, Institute of Basic Medical Sciences, P.O. Box 1122 Blindern, 0317, Oslo, Norway.
| | - Sarah Ward
- Centre for Genetic Origins of Health and Disease (GOHaD), The University of Western Australia, M409, 35 Stirling Hwy, Crawley, WA, 6009, Australia.
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Lee J, Cha ES, Jeong M, Lee WJ. A national survey of occupational radiation exposure among diagnostic radiologic technologists in South Korea. RADIATION PROTECTION DOSIMETRY 2015; 167:525-531. [PMID: 25380759 DOI: 10.1093/rpd/ncu330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 10/03/2014] [Indexed: 06/04/2023]
Abstract
The objective of this study was to investigate representative occupational characteristics and radiation exposure for South Korean radiologic technologists. The authors conducted a national survey by stratified sampling of South Korean administrative districts and types of medical facilities. A total of 585 technologists were surveyed, and survey data were linked with dosimetry data from the National Dose Registry. A total of 73 % of radiologic technologists sampled were male, 62 % were younger than age 40 and 86.5 % began employment after 1990. The most frequent practices among radiologic technologists were diagnostic routine X-ray followed by computed tomography (CT) and portable X-ray. Male workers were more frequently involved in CT, portable X-ray and interventional radiology whereas female workers carried out most mammography procedures. The average annual effective dose was 2.3 mSv for male and 1.3 mSv for female workers. The dose was significantly higher for workers in the provinces and those who had recently started work.
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Affiliation(s)
- Jeeyoung Lee
- Graduate School of Public Health, Korea University, Seoul, South Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Meeseon Jeong
- Radiation Health Research Institute, Korea Hydro and Nuclear Power Co. Ltd., Seoul, South Korea
| | - Won Jin Lee
- Graduate School of Public Health, Korea University, Seoul, South Korea Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
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McKeown SR, Hatfield P, Prestwich RJD, Shaffer RE, Taylor RE. Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation. Br J Radiol 2015; 88:20150405. [PMID: 26462717 PMCID: PMC4984935 DOI: 10.1259/bjr.20150405] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/01/2015] [Accepted: 10/12/2015] [Indexed: 12/14/2022] Open
Abstract
Most radiotherapy (RT) involves the use of high doses (>50 Gy) to treat malignant disease. However, low to intermediate doses (approximately 3-50 Gy) can provide effective control of a number of benign conditions, ranging from inflammatory/proliferative disorders (e.g. Dupuytren's disease, heterotopic ossification, keloid scarring, pigmented villonodular synovitis) to benign tumours (e.g. glomus tumours or juvenile nasopharyngeal angiofibromas). Current use in UK RT departments is very variable. This review identifies those benign diseases for which RT provides good control of symptoms with, for the most part, minimal side effects. However, exposure to radiation has the potential to cause a radiation-induced cancer (RIC) many years after treatment. The evidence for the magnitude of this risk comes from many disparate sources and is constrained by the small number of long-term studies in relevant clinical cohorts. This review considers the types of evidence available, i.e. theoretical models, phantom studies, epidemiological studies, long-term follow-up of cancer patients and those treated for benign disease, although many of the latter data pertain to treatments that are no longer used. Informative studies are summarized and considered in relation to the potential for development of a RIC in a range of key tissues (skin, brain etc.). Overall, the evidence suggests that the risks of cancer following RT for benign disease for currently advised protocols are small, especially in older patients. However, the balance of risk vs benefit needs to be considered in younger adults and especially if RT is being considered in adolescents or children.
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Affiliation(s)
| | - Paul Hatfield
- Leeds Cancer Centre, St James's University Hospital, Leeds, UK
| | | | - Richard E Shaffer
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - Roger E Taylor
- College of Medicine, Swansea University, South West Cancer Centre, Swansea, UK
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Kitahara CM, Linet MS, Drozdovitch V, Alexander BH, Preston D, Simon SL, Freedman DM, Brill AB, Miller J, Little MP, Rajaraman P, Doody MM. Cancer and circulatory disease risks in US radiologic technologists associated with performing procedures involving radionuclides. Occup Environ Med 2015. [DOI: 10.1136/oemed-2015-102834] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Khisroon M, Khan A, Naseem M, Ali N, Khan S, Rasheed SB. Evaluation of DNA damage in lymphocytes of radiology personnel by comet assay. J Occup Health 2015; 57:268-74. [PMID: 25752658 DOI: 10.1539/joh.14-0154-oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The importance of X-rays as a diagnostic medical tool cannot be denied. However, continuous exposure to X-rays can cause DNA damage. This study aimed to use the comet assay technique to investigate the level of DNA damage in lymphocytes due to X-rays in occupationally exposed personnel. METHODS Blood samples were collected from 74 exposed and 70 control subjects for analysis. A total of 100 randomly captured cells from each slide were examined using an epifluorescent microscope. The comets were analyzed by a visual scoring method according to comet tail length. RESULTS The results indicated a significant increase (p<0.05) in DNA damage in X-rays technicians (129.8 ± 17.2) as compared with the control group (53.0 ± 25.0). A significant increase (p<0.02) in DNA damage was also observed with an increase in exposure duration of technicians because of their service length. CONCLUSIONS The present study suggests that the exposed radiology personnel should carefully comply with radiation protection procedures such as wearing of lead apron during diagnostic procedures and minimize radiation exposure where possible to avoid potential genotoxic effects due to X-rays.
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Lee WJ, Ha M, Hwang SS, Lee KM, Jin YW, Jeong M, Jun JK, Cha ES, Ko Y, Choi KH, Lee JE. The radiologic technologists' health study in South Korea: study design and baseline results. Int Arch Occup Environ Health 2014; 88:759-68. [PMID: 25408461 DOI: 10.1007/s00420-014-1002-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/10/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the study design, methods, and baseline results of a prospective cohort of radiologic technologists which we have initiated in South Korea. METHODS The cohort participants were enrolled through a self-administered questionnaire survey administered from April 2012 to May 2013. Survey data were linked with radiation dosimetry, a cancer registry, and health insurance data by personal identification numbers. A nationwide representative survey was also conducted using a stratified random sampling design with face-to-face interviews. RESULTS A total of 12,387 radiologic technologists were enrolled, which accounted for approximately 63% of all diagnostic radiologic technologists working in South Korea. For nationwide survey, 585 workers were interviewed using the detailed questionnaire, and buccal cells were also collected by scraping the inside of the cheek. The majority of study subjects were under 50-year-old and male workers. The average annual effective dose of radiation declined both men (from 2.75 to 1.43 mSv) and women (from 1.34 to 0.95 mSv) over the period of 1996-2011. A total of 99 cancers (66 cancers in men and 33 in women) were reported from 1992 to 2010. The standardized incidence ratio of all cancer combined was significantly lower in men (SIR = 0.75, 95% CI 0.58-0.96) than general population, but the ratios for thyroid cancer were significantly higher than expected among both men and women. CONCLUSIONS This cohort provides comprehensive information on work activities and health status of diagnostic radiologic technologists. In addition, the nationwide representative sample provides unique opportunities compared with previous radiologic technologist studies.
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Affiliation(s)
- Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,
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Liu JJ, Freedman DM, Little MP, Doody MM, Alexander BH, Kitahara CM, Lee T, Rajaraman P, Miller JS, Kampa DM, Simon SL, Preston DL, Linet MS. Work history and mortality risks in 90 268 US radiological technologists. Occup Environ Med 2014; 71:819-35. [DOI: 10.1136/oemed-2013-101859] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Thyroid cancer incidence in Chornobyl liquidators in Ukraine: SIR analysis, 1986-2010. Eur J Epidemiol 2014; 29:337-42. [PMID: 24705729 DOI: 10.1007/s10654-014-9896-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/23/2014] [Indexed: 10/25/2022]
Abstract
We studied thyroid cancer incidence in a cohort of 150,813 male Chornobyl clean-up workers ("liquidators") from Ukraine by calculating standardized incidence ratio (SIR) using national cancer statistics. Follow-up began on the liquidator's registration date with the Chornobyl State Registry of Ukraine (the earliest date was 05. 05. 1986) and continued through December 31, 2010, date of thyroid cancer diagnosis, date of death, or date of last known vital status, whichever came first. There were 196 incident thyroid cancers in the study cohort with an overall SIR of 3.50 [95 % confidence interval (CI) 3.04-4.03]. A significantly elevated SIR estimate of 3.86 (95 % CI 3.26-4.57) was observed for liquidators who had their first clean-up mission in the Chornobyl zone in 1986, when levels of external and internal exposure to radiation were highest; the SIR estimates for later calendar years of first clean-up mission, while significantly elevated, were lower. The SIR estimates were elevated throughout the entire follow-up period but were especially high 10-18 years after the accident: 4.62 (95 % CI 3.47-6.15) and 4.80 (95 % CI 3.78-6.10) for the period 1995-1999 and 2000-2004, respectively. Our findings support the growing evidence of increased thyroid cancer rates among Chornobyl liquidators. Although this could be partially attributed to increased medical surveillance, the observed pattern of SIR increase warrants further investigation of a potential contribution of radiation exposure to the elevated thyroid cancer rates in this large population.
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Abstract
The atomic bomb and other studies have established with certainty that moderate-to-high doses of radiation cause many types of solid cancer and leukemia. Moving down the dose range to the vicinity of 100-200 mSv, the risks become fuzzy and then unknown at low doses on the order of 10-20 mSv. Nor have low-dose experimental studies provided definitive answers: some have suggested there may be adverse biological effects in the range of 5-50 mSv, while others support a "no risk" interpretation. Epidemiologic data contain intrinsic "noise" (variation by known and unknown factors related to genetics, lifestyle, other environmental exposures, sociodemographics, diagnostic accuracy, etc.) so are generally too insensitive to provide compelling answers in the low-dose range. However, there have been recent provocative reports regarding risk from relatively low-dose occupational and medical radiation exposures that warrant careful consideration. Summaries of the largest studies with low-dose or low dose-rate radiation exposure provide suggestive evidence of risk for solid cancer and stronger evidence for leukemia risk. Recently, interest in health endpoints other than cancer also has risen sharply, in particular the degree of cardiovascular and cataract risk following doses under 1 Sv. Data regarding cardiovascular disease are limited and fuzzy, with suggestions of inconsistencies, and the risk at low doses is essentially unknown. The evidence of cataract risk after low dose-rate exposures among those conducting interventional medical radiological procedures is becoming strong. The magnitude of radiation impacts on human health requires fuller documentation, especially for low-dose or low dose-rate exposures. From the epidemiologic vantage point, this will require longer observation of existing irradiated cohorts and development of new informative cohorts, improved accuracy in dose assessments, more attention to confounding variables, and more biosamples from irradiated groups to enable translational radiobiological studies. Introduction of Radiation Impacts on Human Health (Video 2:02, http://links.lww.com/HP/A35).
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Affiliation(s)
- Roy E Shore
- *Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
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Korir GK, Wambani JS, Korir IK, Tries M, Kidali MM. Frequency and collective dose of medical procedures in Kenya. HEALTH PHYSICS 2013; 105:522-533. [PMID: 24162056 DOI: 10.1097/hp.0b013e31829c35f4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded. The individual and collective radiation burdens of more than 62 types of pediatric and adult radiological examinations were quantified using effective and collective dose. The average effective dose for each radiological examination was assessed from the x-ray efficiency performance tests and patient data from over 30 representative radiological facilities. The results found indicated that over 3 million x-ray procedures were performed in 2011, resulting in an annual collective effective dose of 2,157 person-Sv and an annual effective dose per capita of 0.05 mSv. The most frequent examinations were general radiography (94%), computed tomography (3.3%), and fluoroscopy (2.5%). Although the contribution of computed tomography was small in terms of frequency, this procedure accounted for 36% of the effective dose per capita. General radiography was the most frequent type of examination with a contribution of 55% of the effective dose per capita.
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Affiliation(s)
- Geoffrey K Korir
- *Department of Physics and Applied Physics, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854; †Radiology Department, Kenyatta National Hospital, Hospital Road, P.O. Box 20723-00202 Nairobi, Kenya; ‡National Nuclear Regulator, Eco Glades 2 Office Park, Block G, Eco Park, Centurion, 0157 South Africa
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