Genotoxic risk in health-care professionals occupationally exposed to low doses of ionizing radiation

Assessment of the Impact of Low-dose Ionizing Radiation Exposure on Health Care Workers: A Study of Methods Used from a Scoping Review

ABSTRACT

Healthcare workers may be exposed to ionizing radiation. Ionizing radiations are an important occupational risk factor for the potential damage they can cause to workers' health. Actually, the attention is focused on diseases caused by damage to radiosensitive organs. The aim of our study is to evaluate the methods used for the assessment of the impact of exposure to low-dose ionizing radiation in a population of healthcare workers (HCWs). The electronic database PubMed was searched by title, abstract, and medical subheadings (MeSH) terms. The extracted data were arranged into tables by dividing bibliographic reference, exposure, and statistical analysis information. The quality assessment was performed with the use of the Newcastle-Ottawa Quality Assessment Scale. The search strategy involved retrieving 15 studies (eight cohorts and seven cross-sectional studies). The univariate tests have been performed in 14 studies (93.3%), and Chi-square and T-test were the most commonly used. Multivariate tests have been performed in 11 studies (73.3%), and the most commonly performed were Logistic and Poisson Regressions. The most rated organ was the thyroid gland (six studies). The annual cumulative effective dose was the most used method to assess the dose rate (seven studies). Due to the characteristics of pathologies involved, a retrospective cohort study with an adequate control group and use of the annual cumulative effective dose to account for exposure could be useful features to obtain the best possible evidence. All the elements were found rarely in studies considered. The need is highlighted for more in-depth studies to investigate this topic.

Effect of simultaneous exposure to inhalational anesthetics and radiation on the adaptive response in operating room personnel

Some operating room personnel, such as orthopedic surgeons, are exposed simultaneously to inhalational anesthetics (IAs) and radiation that both can cause DNA damage. Some studies have shown that low doses of radiation reduce DNA damage when the cells are followed by a higher dose of the same or related agent. This study, therefore, set out to compare DNA damage in the anesthesiologists, radiologists, orthopedic surgeons, and healthcare staff (non-exposed group). In this cross-sectional study, breathing zone concentrations of anesthetic gas nitrous oxide (N₂O) were measured in the studied groups using standard method. Additionally, DNA damage was measured by micronucleus (MN) assay. The mean concentrations of N₂O in the anesthesiologists and orthopedic surgeons were 450.27 ± 327.44 ppm and 313.64 ± 216.14 ppm, respectively. The mean annual exposure to X-rays radiation in radiologists and orthopedic surgeons was 15.65 ± 8.46 mSy/year and 3.56 ± 1.32 mSy/year, respectively. MN frequencies were significantly higher in anesthesiologists and radiologists exposed to IAs and X-rays radiation respectively than in the non-exposed healthcare staff. While, there were no statistically significant differences between MN frequencies of orthopedic surgeons exposed to both IAs and radiation and healthcare staff. These findings suggest that an earlier exposure of orthopedic surgeons to a small dose of ionizing radiation can increase their resistance to genotoxicity caused by high doses of N₂O, a phenomenon that is called adaptive response.

Factors associated with genetic damage - an analysis integrating human populations from Southern Brazil

Socioeconomic and demographic factors, lifestyle and cultural characteristics may play an important role in the development of genetic damage. This damage represents a potential health risk to an individual and increases the risk of developing negative outcomes. The aim of this study was to investigate the association of a set of factors and genetic damage by gathering data from previously studied populations in southern Brazil. This study analyzed data related to genetic damage and socioeconomic, demographic, and lifestyle variables of 514 individuals aged 18 to 64 years, residing in 8 cities located in the extreme south of the Brazil. A total of twelve factors were considered in the analysis, and of these seven had some association with the frequency of micronucleus or some parameter of the comet assay. Interestingly, age was a factor weakly associated with genetic damage, while skin color, occupational exposure, drug use, exposure to radiation, and the cultural habit of consuming chimarrão were shown to be associated with genetic damage when analyzed using multivariate regression. Therefore, we suggest that yerba mate consumption is a confounding factor and should be considered in cytogenetic studies in the southern region of South America. These results reinforce the need for human biomonitoring studies to include consideration of a broad range of population and cultural characteristics when seeking to identify relevant associations.

Brazilian workers occupationally exposed to different toxic agents: A systematic review on DNA damage

The evaluation of genotoxicity in workers exposed to different toxic agents is very important, especially considering the association between these exposures in a chronic context and DNA damage. Assessing biomarkers of exposure and, when possible, early biomarkers of effect, contributes to elucidating the potential toxic mechanisms involved in genotoxicity and its contribution to chronic non-communicable diseases. In Brazil, the biggest country in South America, workers are exposed to hazardous physical and chemical agents. Considering that these exposures occur, in most cases, throughout the worker's whole life, this is an important public health concern in Brazil. Therefore, this systematic review aims to analyze occupational exposure to chemical and physical agents and the association with DNA damage in studies carried out in Brazil from 1980 to 2021. A systematic and comprehensive literature search was performed in different databases based on occupational exposure to chemical and physical agents and DNA damage. Only full articles on studies that investigated experimental evidence on occupational exposure in Brazil and assessed DNA damage were included, amounting to 89 articles. Five main occupational exposure groups were identified: pesticides (36%), organic solvents (20%), dust and particles (16%), metals (11%), and ionizing radiation (6%). Another group called "others" included studies (11%) that did not fall into these main groups. It was found that comet assay and micronucleus tests are the most adopted methods to detect DNA damage. Occupational exposures were most associated with DNA damage. However, further improvements in study design would be needed to better characterize the association between biomonitoring and DNA damage, particularly to account for confounding factors.

The modulation of oxidative stress and DNA damage to radiology technicians by repair enzymes XRCC1 and XRCC3 The association of oxidative stress and DNA damage with XRCC1 and XRCC3 polymorphisms in radiology technicians

Ionizing radiation has widespread use in medicine in the diagnosis and treatment of many medical conditions. Radiology technicians are one group that is occupationally exposed to low doses of radiation. There are questions regarding whether low dose exposure to radiation could have long-term health consequences. Assessing the effect of radiation on genetic material is essential for appraising long-term health results. Hereditary variations in DNA repair genes cause differentiation in individual responses to radiation related health effects. This study aimed to determine oxidative stress and DNA damage, and their relationship to XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) polymorphisms in radiology technicians occupationally exposed to low dose radiation. Peripheral blood samples were collected from 45 radiology technicians and age-matched with 40 healthy control individuals working in office environments. Our results showed that radiology technicians had significantly greater oxidative stress and DNA damage than the control group, and women appeared more susceptible to occupational radiation exposure than men. Individuals with wild-type genotypes for XRCC1 (Arg/Arg) and XRCC3 (Thr/Thr) had less DNA damage. Lower DNA damage levels could be explained by the enhanced capacity to repair low dose radiation induced DNA damage. Further studies are needed to evaluate the role of DNA repair genes in individuals that are occupationally exposed to low dose radiation.