Objective: To analyze the characteristics and its influencing factors of occupational injury among clinical nuclear medicine staff, and to put forward suggestions for formulating relevant radiation protection intervention measures. Methods: In March 2022, a study was conducted involving 12 medical institutions engaged in nuclear medicine in Gansu Province. The occupational health examination data of 1451 clinical nuclear medicine staff were analyzed. The study subjects were divided into two groups based on the median annual effective dose of external exposure in 2022: Group A (annual effective dose ≤0.2 mSv, n=927) and group B (annual effective dose >0.2 mSv, n=524). The effects of annual effective dose, age, seniority, gender and occupational category on occupational health of clinical nuclear medicine staff were analyzed. Classification variables between groups were compared with Pearson χ(2) test. Multivariate logistic regression was used to analyze the influencing factors of the abnormal results. Results: The abnormal rates of white blood cell count (WBC), red blood cell count (RBC) and hemoglobin (HGB) in female clinical nuclear medical staff were higher than those in males, and the differences were statistically significant (P<0.001). The abnormal rates of WBC and HGB in clinical nuclear medicine staff of different occupational categories were statistically significant (P<0.05). The abnormal rates of RBC and HGB of clinical nuclear medicine staff in annual effective dose group B were higher than those in group A, and the differences were statistically significant (P<0.05). Multivariate logistic regression results showed that the abnormal risks of RBC in annual effective dose group B was 2.465 times of that in group A, the abnormal risks of RBC, WBC and HGB in females were 9.354, 2.939 and 6.760 times of those in males, respectively. The abnormal risk of WBC in the radiotherapy group was 2.334 times of that in general radiotherapy group. The abnormal risk of lens in nuclear medicine group was 2.459 times of that in general radiotherapy group. The abnormal risk of ECG and lens in ≥35 years old age group were 1.814 times and 1.969 times of those in <35 years old age group, respectively. The abnormal risk of lens of the ≥10 working years group was 1.899 times of that in the <10 working years group. The risk of lymphocyte micronucleus abnormality in the interventional group was 1.481 times of that in the general radiotherapy group, the risk of lymphocyte micronucleus abnormality in females was 2.215 times of that in males. The risk of lymphocyte micronucleus abnormality and lymphocyte chromosome aberration in ≥35 years old age group were 2.552 and 2.266 times of those in <35 years old age group, respectively. The risk of lymphocyte micronucleus abnormality in the group with≥10 working years was 1.443 times of that in<10 working years group (P<0.05) . Conclusion: Long-term low-dose ionizing radiation has a certain effect on the lens and genetic indexes of clinical nuclear medicine staff.
目的： 分析临床核医学工作人员职业损伤特点及其影响因素，为制定相关辐射防护干预措施提出建议。 方法： 于2022年3月，选择甘肃省开展核医学相关工作的12家医疗机构，对其1 451名临床核医学工作人员职业健康检查资料进行分析，根据2022年外照射年有效剂量中位数将研究对象分为两组：A组（年有效剂量≤0.2 mSv，共927人）、B组（年有效剂量>0.2 mSv，共524人）。分析年有效剂量、年龄、工龄、性别和职业类别等因素对临床核医学工作人员职业健康的影响。分类变量组间比较用Pearson χ(2)检验。用多因素logistic回归分析各项结果异常的影响因素。 结果： 女性临床核医学工作人员白细胞计数（WBC）、红细胞计数（RBC）、血红蛋白（HGB）异常率高于男性，差异均有统计学意义（P<0.001）；不同职业类别临床核医学工作人员WBC异常率和HGB异常率差异有统计学意义（P<0.05）；年有效剂量B组临床核医学工作人员RBC和HGB异常率高于A组，差异均有统计学意义（P<0.05）；多因素logistic回归结果显示，年有效剂量B组临床核医学工作人员RBC异常风险是A组的2.465倍；女性RBC、WBC、HGB异常风险分别是男性的9.354、2.939、6.760倍；放疗组临床核医学工作人员WBC异常风险是普放组的2.334倍；核医学组眼晶状体异常风险是普放组的2.459倍；≥35岁年龄组心电图异常、眼晶状体异常风险分别是<35岁年龄组的1.814、1.969倍，工龄≥10年组眼晶状体异常风险是工龄<10年组1.899倍。介入组淋巴细胞微核异常风险是普放组的1.814倍，女性淋巴细胞微核异常风险是男性的2.215倍，≥35岁年龄组淋巴细胞微核异常风险和淋巴细胞染色体畸变风险分别是<35岁年龄组的2.552、2.266倍，工龄≥10年组淋巴细胞微核异常风险是工龄<10年组的1.443倍（P<0.05）。 结论： 长期小剂量电离辐射对临床核医学工作人员眼晶状体及遗传学指标存在一定程度的影响。.
Keywords: Clinical nuclear medical staff; Influencing factors; Nuclear medicine; Occupational health.