Review of individual dose monitoring and health risk for interventional radiology workers

Abstract

Abstract: In recent years,the application of interventional radiology has expanded and has more attention to the occupational radiation exposure and associated risks for interventional radiology workers. This review analyses the radiation dose received by interventional radiology workers,methods of individual dose monitoring,and corresponding limitations,highlights the necessity of radiation epidemiology studies and future research directions,aims to provide a scientific basis for establishing a relatively complete dose health monitoring system and radiation protection system of interventional radiology workers.

Key words: Interventional radiology workers, Individual dose, Radiation-induced health effects

CLC Number:

R148

JIANG Wenwen, CUI Limeng, DING Kuke, LIANG Li, YU Runqiu, MA Yongzhong. Review of individual dose monitoring and health risk for interventional radiology workers. [J]OCCUPATION AND HEALTH, 2025, 41(12): 1707-1713.

References

[1] TAMAM N,SALAH H,ALMOGREN K S,et al.Evaluation of patients' and occupational radiation risk dose during conventional and interventional radiology procedures[J].Radiat Phys Chem,2023,207:1-4.
[2] 李宝欣,李亚京,于磊,等.北京地区介入放射诊疗资源与防护状况调查与分析[J].中华放射医学与防护杂志,2022,42(7):531-537.
[3] SZUMSKA A,BUDZANOWSKI M,MILCEWICZ-MIKA I,et al.Implementation of eye-lens dosimetry in Poland[J]. Radiat Phys Chem,2020, 170:1-5.
[4] LIU G,ZHANG R,LI Y,et al.Study of low-dose radiation workers ionizing radiation sensitivity index and radiation dose-effect relationship[J].Health Phys,2022,123(4):332-339.
[5] LITTLE M P,AZIZOVA T V,RICHARDSON D B,et al.Ionising radiation and cardiovascular disease:Systematic review and meta-analysis[J].Br Med J,2023,380:1-18.
[6] CHARTIER H,FASSIER P,LEURAUD K,et al.Occupational low-dose irradiation and cancer risk among medical radiation workers[J].Occup Med,2020,70(7):476-484.
[7] LI M,DENG L,ZHOU W,et al.Trends of occupational exposure to ionizing radiation in Central China for the period 2000-2021[J].Appl Radiat Isot,2024,208:1-7.
[8] 黄强,黄锐,刁军,等.重庆市介入放射工作人员个人剂量监测情况分析[J].现代预防医学,2022,49(11):1955-1960.
[9] DENG J,FAN S,WANG T,et al.Trends and distribution analysis of occupational exposure from medical practices in china(2010-2016)[J]. Health Phys,2019,117(6):656-660.
[10] 胡新梅,王忠立,嵇志刚,等.宝鸡市部分介入放射学工作人员眼晶状体和手指剂量分析[J/OL].中国辐射卫生,2025:1-11[2025-04-16].http://kns.cnki.net/kcms/detail/37.1206.R.20250218.1249.002.html.
[11] 中华人民共和国国家质量监督检验检疫总局.电离辐射防护与辐射源安全基本标准:GB 18871—2002[S].北京:中国标准出版社,2002:35-36.
[12] 郝述霞,王博,邓君,等.2017年我国19省份医疗机构放射工作人员外照射个人监测异常结果分析[J].中华放射医学与防护杂志,2021,41(2):99-103.
[13] 张显鹏,周涛,张巍,等.2016—2020年山东省部分放射工作人员职业性外照射个人剂量监测结果分析[J].中华放射医学与防护杂志,2023,43(2):118-123.
[14] 周宁,邓磊,王哲,等.2014—2018年江西省医用放射工作人员外照射个人剂量监测结果分析[J].中华放射医学与防护杂志,2021,41(2):116-121.
[15] 王芳,王洁,杨海燕,等.甘肃省放射人员外照射个人剂量水平分析[J].职业与健康,2024,40(7):885-888.
[16] 张萌. 2022年深圳市介入放射工作人员职业健康状况分析[D].长春:吉林大学,2024.
[17] 杨雪莹,郝培,于津伟,等.2016至2020年天津市介入放射学工作人员个人剂量监测结果分析[J].中华劳动卫生职业病杂志,2022,40(9):684-688.
[18] 张伟佳,张雨,师依婷,等.2016—2017年介入放射学工作人员职业性外照射个人剂量水平调查分析[J].中国辐射卫生,2019,28(1):55-58.
[19] 张蓝芮,董娟聪.我国介入放射工作人员职业健康的研究进展[J].辐射防护通讯,2022,42(3):1-5.
[20] 乔宝军,张子扬,陈中兴,等.辽宁省307名介入放射工作人员个人剂量监测结果分析[J].中国辐射卫生,2022,31(3):301-305.
[21] 张雨,李鑫,刘铁,等.某地区医疗放射工作人员职业性外照射个人剂量水平与分析[J].工业卫生与职业病,2024,50(1):67-70.
[22] BORREGO D,YOUER C,BALTER S,et al,Collar badge lens dose equivalent values among united states physicians performing fluoroscopically guided interventional procedures[J].J Vasc Interv Radiol,2022,33(3):219-224.
[23] 杨艳艳,朱晨笛,周春莲,等.2018—2020年某医院介入放射工作人员外照射个人剂量监测结果分析[J].中国辐射卫生,2022,31(6):698-703.
[24] 何丽娟,张岭,何廷贵,等.基于PBU-60体模的介入患者及职业人员辐射剂量学研究[J].中国辐射卫生,2021,30(4):417-422.
[25] TU C-Y,LIN C-J,YANG B-H,et al.Cardiac catheterization real-time dynamic radiation dose measurement to estimate lifetime attributable risk of cancer[J]. PLoS One,2020,15(6):1-12.
[26] LI M,FAN S,ZHANG X,et al.Assessment of occupational exposure to eye lens dosimetry for interventional radiology workers in china during 2017-2019[J].Health Phys,2022,123(3):229-237.
[27] International Commission on Radiological Protection.ICRP publication 118:ICRP statement on tissue reactions/early and late effects of radiation in normal tissues and organs-threshold doses for tissue reactions in a radiation protection context[J].Ann ICRP,2012,41(1-2):1-322.
[28] 苏垠平,张品华,崔诗悦,等.2019—2021年我国介入放射工作人员眼晶状体剂量水平调查与分析[J].中华放射医学与防护杂志,2023, 43(6):457-461.
[29] BORREGO D,KITAHARA C M,BALTER S,et al.Occupational doses to medical staff performing or assisting with fluoroscopically guided interventional procedures[J]. Radiology,2020,294(2):353-359.
[30] WONG J H D,ANEM L E A,TAN S,et al.Eye lens dose of medical personnel involved in fluoroscopy and interventional procedures at a Malaysian Hospital[J].Phys Med,2019,68:47-51.
[31] PEKKARINEN A,LINDHOLM C,KORTESNIEMI M,et al.Staff eye lens dose in interventional radiology and cardiology in Finland[J]. Phys Med,2022,98:1-7.
[32] PSARRAS M,PLOUSSI A,CARINOU E,et al.Radiation doses to the eye lens and forehead of interventional radiologists:How high and on what grounds?[J].Radiat Prot Dosim,2020,190(2):150-157.
[33] 张华东,吴梦云,张燕,等.重庆市部分介入放射学工作人员眼晶状体的剂量监测与结果分析[J].国际放射医学核医学杂志,2022,46(3):146-151.
[34] ROBERTO M R,LEITE L M A,CRUZ A R P,et al.Medical staff dose estimation during pediatric cardiac interventional procedures[J].J Radiol Prot,2024,44(2):1-5.
[35] 潘秋秋,邓君,李梦雪,等.介入手术中放射工作人员眼晶状体剂量监测与分析[J/OL].中国辐射卫生,2025:1-11[2025-04-21].http://kns.cnki.net/kcms/detail/37.1206.R.20250211.1057.002.html.
[36] NAGAMOTO K,KAWACHINO T,SUETSUGU Y,et al.Eye lens dose in spine surgeons during myelography procedures:A dosimetry study[J]. J Radiol Prot,2023,43(4):1-6.
[37] 赵红枫,岳保荣,薛娴.五种介入程序中职业人员手部受照剂量水平的评估[J].中华放射医学与防护杂志,2019,39(4):303-308.
[38] 柏彭开,冯喜明,储晓阳,等.基于真实世界数据放射介入医生辐射受照剂量研究[J].现代仪器与医疗,2023,29(5):27-35.
[39] RAMANAN B,PIZANO A,TIMARAN C H,et al.Operator lower leg radiation dose during fluoroscopically guided interventions is effectively reduced by wearing lead-equivalent leg wraps[J].Ann Vasc Surg,2023,89:161-165.
[40] 中华人民共和国全国人民代表大会常务委员会.中华人民共和国职业病防治法[S].北京:法律出版社,2012:5-8.
[41] 中华人民共和国卫生部.放射工作人员职业健康管理办法:卫生部令第55号[EB/OL].(2007-06-03)[2025-04-21]. http://www.nhc.gov.cn/wjw/bmgz/200804/69aa46cc0bd142d9beb025a857f90775.shtml.
[42] 国家卫生健康委员会.职业性外照射个人监测规范:GBZ 128—2019[S].北京:中国标准出版社,2020:1-22
[43] International Commission on Radiological Protection.ICRP publication 139:Occupational radiological protection in interventional procedures[J].Ann ICRP,2018,47(2):1-118.
[44] National Council on Radiation Protection and Measurements. NCRP report no.166-population monitoring and radionuclide decorporation following a radiological or nuclear incident[Z].USA:MD,2010:1-239.
[45] International Commission on Radiological Protection. ICRP publication 85:Avoidance of radiation injuries from medical interventional procedures[J].Ann ICRP,2000,30(2):7-67.
[46] 崔力萌,冯泽臣,靳国梁,等.主动式个人剂量计(APD)在脉冲辐射场中的性能与应用[J].中国辐射卫生,2024,33(4):353-357.
[47] 崔力萌,靳国梁,马小龙,等.主动式个人剂量计在脉冲辐射场中的性能与应用研究进展[J].首都公共卫生,2023,17(4):252-255.
[48] LIMENG C,QINGXIANG T,ZECHEN F,et al.What happened when medical staff in Beijing,China wore over-apron dosemeters?[J].Radiat Prot Dosim,2023,199(11):1190-1194.
[49] 李小亮,孙全富,刘建香,等.2019年全国监测医院辐射防护用品配备及放射工作人员职业健康管理现状[J].中华放射医学与防护杂志,2020,40(10):753-757.
[50] 张璇,杨扬,李德红,等.Hp(3)测量与量值传递研究进展[J].辐射防护,2021,41(5):385-393.
[51] National Council on Radiation Protection and Measurements.Use of personal monitors to estimate effective dose equivalent and effective dose to workers for external exposure to low-let radiation[Z].USA:MD,1995:1-99.
[52] 张璇,郭文,丁艳秋,等.介入放射学工作人员个人有效剂量监测方法研究进展[J].中华放射医学与防护杂志,2018,38(5):395-400.
[53] DOMIENIK-ANDRZEJEWSKA J,BRODECKI M,ZMYŚLONY M. Correlation of eye lens doses and personal dose equivalent measured on the arm of interventional cardiologists for a retrospective assessment of doses to operators' eye lens[J].Radiat Prot Dosim,2020,189(3):271-278.
[54] CHAI L,CHEN L,YANG C-P,et al.Evaluation of CdZnTe spectrometer performance in measuring energy spectra during interventional radiology procedure[J].Nucl Sci Tech,2019,30(9):137.
[55] 吴涛,高韩,徐一鹤,等.使用MRKPs模型计算介入手术第一术者受照剂量[C]//中国医学装备大会暨2022医学装备展览会论文汇编(上册).北京:中国医学装备协会,2022:391-392.
[56] SANTOS C J,SANTOS W S,NEVES L P,et al.Monte Carlo simulation for assessment of occupational doses in pediatric cardiology procedures[J].Radiat Meas,2024,172:1-10.
[57] BALCAZA V G,BOSMAN D F,BADAL A,et al.PyMCGPU-IR Monte Carlo code test for occupational dosimetry[J]. Radiat Prot Dosim,2023, 199(8-9):730-735.
[58] 尹禹臣,王轩,许文星,等.一起介入手术过量照射事件中术者关键组织器官吸收剂量和有效剂量的蒙特卡罗估算[J].中华放射医学与防护杂志,2024,44(8):688-692.
[59] YIN Y,WANG X,KONG X,et al.Physical dosimetric reconstruction of a case of large area back skin injury due to overexposure in an interventional procedure[J].Radiat Med Prot,2022,3(1):3-8.
[60] 范胜男,谢芹,李梦雪,等.介入治疗第一术者眼晶状体受照剂量蒙特卡罗模拟与分析[J].中国辐射卫生,2023,32(6):597-602.
[61] BARBOSA A H P,MEDEIROS R B,CORPA A M R,et al.Prevalence of lens opacity in interventional cardiologists and professional working in the hemodynamics in brazil[J].Arq Bras Cardiol,2019,112(4):392-399.
[62] PICANO E,VANO E,DOMENICI L,et al.Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure[J]. Bmc Cancer,2012,12(157):1-13.
[63] RYAN J L.Ionizing radiation:The good,the bad,and the ugly[J].J Invest Dermatol,2012,132(3,Part 2):985-993.
[64] SHIM D M,KIM Y M,OH S K,et al.Radiation induced hand necrosis of an orthopaedic surgeon who had treated a patient with fluoroscopy-guided spine injection[J].J Korean Orthop Assoc,2014,49(3):250-254.
[65] 鲁碧峰,石娜,齐素芹,等.低剂量电离辐射对放射工作人员血液指标的影响[J].职业卫生与应急救援,2020,38(5):487-489.
[66] LEE Y,LEE W J,JIN Y W,et al.Interventional radiologists have a higher rate of chromosomal damage due to occupational radiation exposure:a dicentric chromosome assay[J].Eur Radiol,2021,31(11):8256-8263.
[67] 牛丽梅,刘刚,李烨,等.医用放射工作人员全血细胞及遗传学影响因素分析[J].中华劳动卫生职业病杂志,2023,41(10):827-831.
[68] 钟皓成,边阳甫,陈慧慧,等.杭州地区介入放射人员职业健康和放射防护现状调查[J].工业卫生与职业病,2024,50(4):364-367.
[69] LINET M S,KITAHARA C M,NTOWE E,et al.Mortality in U.S. physicians likely to perform fluoroscopy-guided interventional procedures compared with psychiatrists,1979 to 2008[J].Radiology,2017, 284(2):482-494.
[70] WANG J X,ZHANG L A,LI B X,et al.Cancer incidence and risk estimation among medical x-ray workers in China,1950-1995[J]. Health Phys,2002,82(4):455-466.
[71] LEE W J,BANG Y J,CHA E S,et al.Lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments[J].Int Arch Occup Environ Health,2021,94(1):139-145.
[72] PARK S,SEO S,LEE D,et al.A cohort study of korean radiation workers:Baseline characteristics of participants[J].Int J Environ Res Public Health,2020,17(7):1-14.