随着核与辐射技术的不断发展,电离辐射已广泛应用于工业、航空和医疗等多个领域.在医疗领域,放射性诊疗设备大大提高了疾病的诊断和治疗效率.如今国民的口腔保健意识日益增强,带来了我国国内口腔诊疗机构的蓬勃发展,同时口腔诊疗机构的放射性诊断设备及相关的放射性工作人员数量增长迅猛.国家相关标准和管理规定规范辐射时间及防护行为,让人们在享受电离辐射便利的同时,降低辐射的有害效应[1].在实践中,各地区的口腔放射诊疗机构对放射防护标准的执行情况不一,无论是综合医院内设的口腔科室还是独立口腔机构均存在违反辐射防护三原则的实践活动.

Objective:To ascertain the distribution of interventional radiodiagnosis and treatment resources and the current situation of radiological protection in Beijing, standardize the interventional radiodiagnosis and treatment, and promote the implementation of radiation protection regulatory measures.Methods:Various medical institutions at differetn levels that perform interventional radiodiagnosis and treatment in Beijing were identified as the survey objects. With special questionnaires designed, the investigation groups at two levels of municipality and district was established to investigate the basic situation of interventional radiology and occupational health monitoring by the end of 2020. The indexes and parameters were analyzed and evaluated under the relevant national regulations and standards.Results:By the end of 2020, there were 93 medical institutions performing interventional radiology in Beijing, together with 236 digital subtraction angiography machines (DSA) with higher than 800 mA. A total of 135 593 cases of interventional radiological surgical operation were performed. There were 40 hospitals annually performing more than 1 000 cases and 41 hospitals perfoming 10-1 000 cases. There were 3 539 interventional radiological workers, with 99.0% holding radiological worker certificates. The passing rates of occupational health examination, personal dose monitoring and radiation protection training were 96.9%, 99.5% and 95.8%, respectively. A total of 3 532 sets of protective articles were provided for the workers, of which 98.9% were equipped with split or integrated lead clothing, but 6.5% were not equipped with lead protective glasses and 54.9% were not equipped with lead protective gloves.Conclusions:The radiation protection management for the interventional radiodiagnosis and treatment is generally good. However, the regulatory mechanism should be further improved based on the current distribution of interventional radiodiagnosis and treatment resources, with focus on strengthening the occupational health examination, the radiation protection training, and the configuration and use of protective equipment.

目的 了解我市健康体检机构放射诊疗工作开展情况,规范健康体检机构放射诊疗行为.方法 依据《北京市卫生和计划生育监督所关于开展2019年健康体检机构放射诊疗专项监督检查工作的通知》的要求,采用现场检查、现场访谈方式开展调查工作.结果 本次健康体检机构的调查表明,北京市健康体检机构放射卫生管理工作总体良好,放射诊疗许可证持有率为100％.健康体检机构的放射诊疗工作以X射线摄影为主,215家健康体检机构共配置的放射诊疗设备822台,其中CT机138台,体检车20台,CT机占16.8％;健康体检机构的X射线摄影设备占总应用频次93％,CT机占总应用频次7.0％.215家健康体检机构全年放射诊疗应用频次约500万人次,被处罚机构占比较低,仅占2.8％,其中给予警告6户次,罚款2户次,发出处罚决定书6份,整改3户.结论 北京市健康体检机构放射卫生管理工作总体良好,在CT机合理应用、防护用品配置等方面仍存在一些问题,需进一步解决.

《职业病防治法》规定"对从事接触职业病危害的作业的劳动者,用人单位应当按照国务院卫生行政部门的规定组织上岗前、在岗期间和离岗时的职业健康检查.对医疗机构放射性职业病危害控制的监督管理,由卫生行政部门依照本法的规定实施."本文通过对一起口腔诊所未按照规定组织职业健康检查,被依法责令限期改正,给予警告,并处五万元罚款的案例进行分析,总结办案过程、经验,对相关问题引发讨论.

《中华人民共和国职业病防治法》规定:"职业健康检查应当由省级以上人民政府卫生行政部门批准的医疗卫生机构承担."本文通过对一起医疗卫生机构出具虚假证明文件,被依法责令立即停止违法行为,没收违法所得,并处10000元罚款的案例进行分析,总结办案过程、探讨经验,并对相关问题引发讨论.

通过采用问卷调查法、定性访谈法对北京地区17个区县的放射卫生监督员进行调查,了解北京地区放射卫生监督机构科室设置及放射卫生监督队伍建设情况,通过档案查询法了解放射卫生监管对象分布情况,从而为北京市放射卫生监管体系改革及加强放射卫生监督工作提供参考依据.结果发现科室设置不合理、放射卫生监督人员配置与被监督对象不匹配、难以胜任高质量的监督检查工作是目前放射卫生监督机构科室建设存在的主要问题.建议对拥有优质放射诊疗资源的区县设置独立的放射卫生监督科室,增加重点监管区域的放射诊疗监督专职人员数量,加强放射卫生监督机构体制建设.

为贯彻落实《中华人民共和国职业病防治法》(以下简称《职业病防治法》)及相关文件精神,加强北京市职业卫生技术服务机构建设,提升技术服务能力和服务质量,了解用人单位对技术服务机构的工作需求,北京市卫生监督所组织开展了《北京市职业卫生技术服务机构满意度评估》调查。调查的目的是了解用人单位对目前我市现有的职业卫生技术服务机构满意度情况、用人单位对技术服务工作需求情况,分析探讨提高我市技术服务机构服务能力的途径和方法,为提升我市技术服务机构能力和水平、加强我市的技术服务机构建设提供有益支持。本次调查为抽查,北京市18个区县共抽取880家用人单位作为本次调查对象。调查结果表明,用人单位对职业卫生技术服务机构的整体满意率为78.9%。

本文作者报道1996～2000年北京市放射工作人员个人剂量的水平和分布、比较各类放射工作受照剂量的差异、分析人员受照剂量的年度变化.