Cardiac catheterization procedures are performed on about 20,000 children with congenital heart disease (CHD) annually in China. The procedure, which involves exposure to ionizing radiation, causes DNA damage and may lead to increased cancer risk. We have studied chromosomal aberrations (CA) in peripheral lymphocytes of CHD children. CA frequencies were assessed in an interventional group of 70 children who underwent cardiac catheterization and a control group of 51 children receiving open-heart surgery. Total CA and all chromosome-type aberrations were higher in the exposed children than in the control group. With respect to the type of septal defect, the translocation frequency was higher in patients with ventricular rather than atrial defects. Cardiac catheterization procedures increase CA frequencies and may also increase the risk of cancer.

Objective To understand effects of the interventional operation on thyroid,peripheral blood indexes and chromosomal aberrations (CA) of peripheral lymphocyte of children with congenital heart disease (CHD).Methods Follow-up studies were conducted in 70 child patients undergoing cardiac catheterization and 23 with open heart surgery as control from 2010 to 2013.Postoperative follow-up examinations included thyroid ultrasound,blood routine indexes and analyses of CAs.Results Difference in thyroid ultrasound abnormality rate was not statistically significant between children with cardiac catheterization and control group (40.0％ vs.43.5％,P ＞ 0.05).There was no significant difference in white blood cell (WBC) count between interventional group and control group (P ＞ 0.05).The effects of disease type and operation time on thyroid ultrasound and WBC count were not observed (P ＞ 0.05).The frequency of chromosome aberrations,including acentric fragment,dicentrics and translocation in interventional group [(0.76 ± 0.07) ％],was higher than in control group [(0.25 ± 0.07) ％,(Z =-3.631,P ＜ 0.05],and the rates of acentric fragment and translocation were also higher in interventional group (Z =-2.531,-2.397,P ＜ 0.05).Conclusions Effect of intervention therapy on thyroid structure and WBC count in children with CHD was not observed,but the genotoxic effects remain in children with cardiac catheterization.

Objective To study the relationship between the risk of malignant tumor and occupational radiation factor among medical diagnostic X-ray workers in Jiangsu province.Methods The retrospective and prospective cohort studies were adopted to investigate the incidence of cancer.Eligible medical diagnostic X-ray workers from the department of radiology in hospitals were selected and assigned into exposure group,while other medical workers from the departments of Internal Medicine,Ear-NoseThroat (ENT) or Pediatrics who attended work at the same period in the same hospital but not engaged in radiation work were regarded as control group during 1950-2011 in Jiangsu province.We calculated the total person-year and analyzed the relative risk (RR) of malignant tumor using Poisson regression model.Results 7 703 participants (3 961 in exposed group and 3 742 in unexposed group) were recruited and followed up,with a total of 315 309 person years and the lost follow-up rate was 6.92％ (533/7 703).During the follow up period,a total of 819 tumor cases were identified (771 were malignant tumors).We found the significant relationship between the risk of malignant tumor and occupational radiation factor,and the RR of solid cancer and total malignant tumor were 1.31 (95％ CI:1.11-1.55) and 1.33 (95％ CI:1.13-1.57),respectively.In addition,the risk of lung cancer in medical diagnostic X-ray workers was significantly higher than that in control group (RR =1.45,95％ CI:1.00-2.09).Conclusions The incidence risk of lung cancer,solid caner and total malignant tumors in medical diagnostic X-ray workers was significantly higher than that in the control group,which might be associated with occupational exposure to ionizing radiation.

Objective To continue following up the cohort members in Jiangsu province who were the largest subgroup in Chinese medical X-ray workers cohort subgroups on radiation carcinogenesis and analysis the cancer risk of medical X-ray workers which might be induced by chronic low-dose ionizing radiation between 1997 and 2011.Methods A retrospective cohort study was utilized to accumulate data.Epicure was applied to compute cumulative person years (with module of Datab) and relative risk (including 95％ CI) of malignant tumor on exposed group(with module of AMFIT) while the factors such as sex and attained-age were adjusted in the cohort members.Results The 7 708 follow-up members included 3 668 medical X-ray workers.The cumulative person-year in the cohort members was 94 651.2 (1997-2011) and its lost rate was 5.79％.During the follow-up period,441 cases had became cancer patients.The relative risk of all cancers was 1.44 (95％ CI:1.18-1.75),so was the solid cancers.Significant elevated risks of cancer were found on lung (RR =1.95,95％ CI:1.30-2.92),esophagus (RR =3.04,95％ CI:1.20-7.70),lymphoma(RR =2.24,95％ CI:0.67-7.48),leukemia(RR =1.57,95 ％ CI:0.33-7.39),throat (RR =2.47) and thyroid (RR =2.80,95 ％ CI:0.24-32.26) among medical X-ray workers.However,The RR of malignant tumors might not be associated with occupational exposure to ionizing radiation if we considered the lost factors (RR =1.2,95％ CI:0.94-1.46)Conclusions The RR of malignant tumors such as the cancer on lung,esophagus,thyroid among the medical X-ray workers in Jiangsu province were enhanced which might be associated with occupational exposure to ionizing radiation.

目的 比较不同放射工作人员的白细胞水平与一般人群的差异,并探索可能的影响因素.方法 采用五个省(市)2011年、2012年和2013年的放射工作人员健康体检数据,与一般人群白细胞计数正常值进行比较,采用单因素分析和多元线性回归分析的方法,研究不同因素对放射工作人员白细胞计数的影响.结果 本研究确认符合要求的研究对象共7314人,其中男性5595人(76.50％),女性1719人(23.50％),平均年龄为(37.71±10.14)岁,白细胞计数均值为(6.29±1.60)×109/L,一般人群白细胞计数为(6.50±1.53)×109/L,放射工作人员白细胞计数较一般人群低3.23％,差异有统计学意义(P＜0.001).女性的白细胞计数低于男性,且在年龄小于50岁的人群中,白细胞计数有随年龄增加而减少的趋势,差异均有统计学意义(P＜0.05).不同省市体检机构的放射工作人员白细胞计数也不同,且差异有统计学意义(P＜0.05).多元线性回归分析结果显示,在调整年龄、性别和地区因素后,不同职业照射类别人员的白细胞计数之间的差异无统计学意义(P＞0.05).结论 放射工作人员白细胞计数在正常医学参考值范围内,但低于一般人群,可能与性别、年龄和不同地区体检机构之间的差异有关,尚不能认为与职业照射类别有关,需要进一步研究.

A pilot study to measure ambient gamma dose rate and radon and thoron progeny concentrations was made for eight dwellings selected in Yangjiang, China. Indoor and outdoor ambient gamma dose rates were 110–370 and 100–220 nGy h −1 , respectively. Doses received from indoor terrestrial radiation were estimated to be 0.6–1.8 mSv year −1 . Radon, thoron and thoron progeny concentrations were 19–98, 18–1120 and 0.4–10.3 Bq m −3 , respectively. This pilot study showed that the position of passive-type monitors to be placed and the deployment period should be carefully determined for estimating reliable annual average concentrations.

Objective To estimate the radiation dose and cancer risk of thyroid for children who underwent head CT or chest CT scans.Methods The parameters used in the CT scans were accessed from the DICOM files through PACS used DCMTK software, then the thyroid radiation dose was estimated with the CT-Expo(C) software and the cancer risk induced by CT scan was projected based on BEIR Ⅱ model combined with the Chinese cancer incidence and lifetime table in 2008.Results CT parameters used for different ages were roughly the same, the thyroid equivalent dose for head CT ranged from 1.2-2.0 mGy, the highest thyroid cancer risk occurs for newborn girls, about 9.6/100 thousand population;while for chest CT the thyroid equivalent dose ranged from 8.1 to 38.0 mGy, the highest thyroid cancer risk was also for newborn girls, about 244.7/100 thousand population.The radiation dose and cancer risk for thyroid decreased with the increased age.Conclusions The radiation dose for thyroid from chest CT was relatively higher than head CT, especially for newborn babies;therefore more protection should be given to the thyroid and other radio-sensitive organs during CT scanning.

Objective: To quantify the radiation dose in the thyroid attributable to different CT scans and to estimate the thyroid cancer risk in pediatric patients. Methods: The information about pediatric patients who underwent CT scans was abstracted from the radiology information system in one general hospital between 1 January 2012 and 31 December 2012. The radiation doses were calculated using the ImPACT Patient Dosimetry Calculator and the lifetime attributable risk (LAR) of thyroid cancer incidence was estimated based on the National Academies Biologic Effects of Ionizing Radiation VII model. Results: The subjects comprised 922 children, 68% were males, and received 971 CT scans. The range of typical radiation dose to the thyroid was estimated to be 0.61–0.92 mGy for paranasal sinus CT scans, 1.10–2.45 mGy for head CT scans, and 2.63–5.76 mGy for chest CT scans. The LAR of thyroid cancer were as follows: for head CT, 1.1 per 100,000 for boys and 8.7 per 100,000 for girls; for paranasal sinus CT scans, 0.4 per 100,000 for boys and 2.7 per 100,000 for girls; for chest CT scans, 2.2 per 100,000 for boys and 14.2 per 100,000 for girls. The risk of thyroid cancer was substantially higher for girls than for the boys, and from chest CT scans was higher than that from head or paransal sinus CT scans. Conclusions: Chest CT scans caused higher thyroid dose and the LAR of thyroid cancer incidence, compared with paransal sinus or head CT scans. Therefore, physicians should pay more attention to protect the thyroid when children underwent CT scans, especially chest CT scans.

随着核技术在各行业的广泛应用，特别是医用放射技术的不断推广，我国放射工作人员的数量正在不断增加。因而，保障相关从业人员的职业健康，提高职业病诊断的科学性、准确性和规范性越来越受到关注。我国政府一直重视职业病诊断工作，针对放射工作人员这一特殊群体也不断加强其职业病诊断的监督管理，制定了专门的法规标准规范职业性放射性疾病的病种范围、诊断和报告制度，并在逐次修订中不断完善。本文回顾了我国职业性放射性疾病病种范围、诊断程序、报告制度的历史沿革，在汇总历史文献报道和作者所参与的相关调查的基础上，整理和分析了直至近年的职业性放射性疾病诊断病例数量及病种分布特征，并讨论了目前职业性放射性疾病诊断中存在的问题及面临的挑战。

[目的]利用放射信息管理系统(RIS)数据信息了解X射线诊断检查的频次分布情况. [方法]通过RIS数据库搜集2012年1月1日至12月31日全年某区医院接受X射线诊断检查时的编号(ID)、性别、出生日期、受检时间、检查部位等相关信息,然后利用SAS软件对数据进行清理及相应的统计处理,调查不同性别、年龄及受检部位的患者接受不同X射线诊断检查类型的频次分布,及依据患者年龄、受检部位统计2012年患者重复接受CT检查的情况.[结果]该医院共有11台医用诊断X射线机,2012年全年共进行416947人次X射线诊断检查.其中,接受计算机X射线摄影/数字化X射线摄影(CR/DR)检查最高,为328484人次;其次为计算机断层扫描(CT)79 897人次;牙科摄影为7303人次.在所有X射线诊断检查中,胸部摄影所占比例最高,约为40.2％;其次为四肢及关节摄影,为27.0％;再次为头部CT检查,约为6.4％.在接受儿童CT扫描的患者中,头部CT检查比例占70.3％.CT重复检查的比例随年龄的增加而增加,0～15岁受检者重复检查的比例约占7.0％; 16～40岁占14.4％; 40岁以上占22.3％. [结论]利用RIS系统可获取详细的X射线诊断照射信息,方法科学且经济可行.除CR/DR以外,CT检查人次数占所有X射线诊断检查人次数的比重较高,其中,头部CT较常见,尤其是儿童.

Objective To ascertain the frequency distribution of CT examinations in children.Method A wide range of information was collected through the radiology information system (RIS),including ID,sex,birth date,examination time,the examined part of body and other relevant ones related to children who underwent CT examinations between Jan 1,2012 and Dec 31,2012.The SAS software was used for data processing and statistical analysis.Results A total of 1 542 children underwent 1 670 examinations,of which 67％ were male.Head CT examination was the most frequent,accounting for 71.9％ of all CT examinations,and followed by the abdomen/pelvis examinations.The number of examinations of children undergoing the repetitive examination accounted for 6.4％; 51.7％ of the examinations was for trauma.The positive rate of CT examination was 51％,dependent upon the age and examined body parts to some extent.The younger patients had lower positive rate,and the positive rate of head CT examination was lower than those in other parts.Conclusions To reduce the possible cancer risk to be induced by the ionizing radiation from CT,justification of CT examination should be considered for children.

目的 了解全国放射卫生机构设置、独立设置的放射卫生部门以及专业技术人员结构状况,分析存在的问题,为放射卫生机构设置及人才队伍建设提供依据.方法 由原卫生部组织,全国31个省、自治区、直辖市及新疆生产建设兵团卫生监督部门组织开展调查,并上报数据,获取全国放射卫生机构情况,岗位设置以及专业技术人员基本资料,按照监督、疾控、职防和其他划分机构类别,按照省、市、县和其他划分机构级别,分别对不同类别和级别放射卫生机构的统计数据进行分析.结果 在全国放射卫生机构31个省级机构中,30个省设有独立的放射卫生部门,市(地)级机构放射卫生机构大部包含在职业卫生技术服务机构中,县(区)级机构与公共卫生在一起;全国放射卫生机构中的平均从业人员为1.6人,省级机构平均从业人员为6.5人,市(地)级机构平均从业人员为3.1人,县(区)级机构从业人员平均数量最低仅为1.2人,监督县(区)级机构平均1.4人;专业人员的职称以中级和初级为主,分别占总人数的42.6％和38.2％;学历构成以大中专为主,分别占总人数的36.6％和34.5％;所学专业以公共卫生为主,占总人数的45.7％,放射卫生和放射医学专业人员较少,分别占5.4％和6.7％,其他专业占39.7％.结论 全国放射卫生市县级大部分机构没有设置独立的放射卫生部门,存在人员不足,专业结构不合理的问题.需尽快制定各级机构的任务要求、人员配置标准,省市级需设置独立的放射卫生机构,要进一步加强各级机构的人才队伍和能力建设,定期参加全国放射卫生检测比对或考核,打造一支技术过硬的专业队伍.

目的调查广东省阳江天然高本底地区（High Background Radiation Areas,HBRA）健康居民血清免疫学指标的表达情况,探讨慢性低剂量辐射免疫生物学效应及作用机制。方法采用随机抽样方法分别从高本底地区的阳西县塘口镇和对照地区（Control Areas,CA）的阳西县横陂镇各选取125名健康男性居民。应用常规ELISA方法检测其中20名居民血清IL-2的表达水平,85名居民血清sIL-2R的表达水平,剩余20名检测p53的表达水平。实验数据由SPSS 16.0统计软件完成。两地区居民血清IL-2、sIL-2R、p53表达差异进行独立样本t检验,检验水准α=0.05.协方差分析观察高本底辐射、年龄、吸烟、饮酒和医疗照射对IL-2、sIL-2R表达的影响。非条件多因素logistic回归分析地区、年龄和吸烟对p53表达率的影响。结果高本底地区健康居民血清IL-2的浓度略高于对照地区,分别为（13.65±10.96）和（12.18±11.61）ng/L;对照地区居民血清sIL-2R的浓度略高于高本底地区,分别为（2181.9±919.5）和（2151.1±692.1）ng/L,高本底和对照地区居民血清p53浓度分别为（6.26±8.01）和（9.81±7.18）U/ml。上述三个指标的统计结果在两地区之间差异无统计学意义。调整地区,吸烟,饮酒和医用照射因素后,发现年龄对两地区居民血清sIL-2R表达水平影响最大,F=13.61,P=0.0003。对地区、年龄和吸烟三因素进行logistic回归分析,结果显示地区是对p53表达率有统计学意义的影响因素,Z=-2.56,P=0.010。结论天然放射性高本底地区居民的免疫功能略强于对照地区,提示长期慢性低剂量电离辐射有增强机体免疫的趋势,但有待进一步探索。

本研究拟应用计算机数据库和地理信息系统(GIS)技术建立江苏省第五次医用X射线工作者肿瘤流行病学调查随访数据库.其方法通过双录入及CHECK程序保证录入数据质量,导入单机版Access数据库管理系统以建立医用诊断X射线工作者队列研究数据库.使用一般统计分析软件完成数据清理和初步分析.拟利用GIS对调查对象进行空间流行病学分析.结果表明,建立由队列随访总表等6个表组成的属性数据库和包括调查对象工作单位、住址信息的GIS数据库,并获得83％队列成员的GIS信息,失访人员比例为9.8％.经过数据录入质量控制及数据清理,建立了医用诊断X射线工作者队列研究数据库,满足队列研究终生累积剂量估算和辐射致癌危险模型分析的条件,并可以采用空间流行病学技术分析显示研究数据.

>2012年10月19日阳江高本底辐射研究40周年暨魏履新研究员90华诞学术成就研讨会在中国疾病预防控制中心辐射防护与核安全医学所(辐射安全所)隆重举行。有关单位领导和代表、辐射安全所现任和离退休的领导同志、老专家、历年来参加高本底研究工作的同志和有关部门负责人等共70人参加了会议。会议由辐射安全所岳保荣副所长主持。

In July 2009, an incident involving a stuck Co-60 source led hundreds of thousands of people to escape Qi County, Henan Province, China, although no medical or environmental consequences were related to the incident. To investigate knowledge about radiation, public risk-perception of radiation, and evaluation of the official response, a survey was conducted in Qi and Hui County (control). Face-to-face questionnaire interviews were conducted among three groups with different educational backgrounds. In total, 1340 valid questionnaires were collected from people interviewed. Knowledge about radiation was low in all groups in both counties, although knowledge in Qi County was higher than that in Hui County (control). More than 40 respondents supported construction of nuclear power plants (NPPs) in China, while only a few supported constructing NPPs in their vicinity. The main reasons for the mass escape following the incident were assumed to be lack of knowledge about radiation, misinformation, the governments failure to disclose information in time and imitation of group behaviour. Over 60 in Group I and II trusted the local government. About 64 disapproved the response of the Qi County government. After the incident, the population in Qi County still knows little about radiation. Although people trust the government, they are dissatisfied with the response of the local government regarding the incident.

Objective To investigate radiation risk perception and nuclear acceptance after the 60Co stuck source incident in June 2009 in Qixian County,Henan Province.Methods From March to April 2010,23 hamlets and 2 schools from 5 towns in Qixian County were selected,while 3 hamlets and 2 schools from 3 towns were used as control in Huixian County,1 35 km away where no any impact of the incident was found.Face-to-face questionnaire survey was conducted among three groups including mass public,elite public(representatives of public opinion,such as physicians,teachers,govemmental officials,administrative personnel,private entrepreneurs),and middie school students(the third grade students in junior middle schools and the first grade students in senior middle schools).Results A total of 1 340 valid questionnaires were collected.The public knowledge levels about radiation and nuclear power were low among all groups in two areas and public knowledge levels in Qixian County were higher than those in Huixian County.In both areas.the knowledge levels of the students were higher tIIan those among the elite public,and that among the general public were the lowest.The knowledge levels of males and those with higher educational levels were higher than those of females and those with lower educational levels.More than 40.0% of the respondents supported the idea to build nuclear power plants in China.but only a small part of them supported to build nuclear power plants in their own areas.The percentages of opponents against local nuclear power plant construction were especially higher among the students and those with higher educational levels.More than 60% of the mass public and elite public believed the explanation of the government.More than 80% of the respondents held negative attitudes towards the performance of the Qixian County Government in dealing with this incident.The student gave the lowest evaluation of the credibility and the specific performance of the local government,whereas the elite public placed themselves between the students and the mass public.The reasons why the local people left their homes to evade risk included rumors(67.2%),lack of radiation knowledge(61.9%),group psychology(59.2%),and failure of the government to inform the truth to the public in time(42.3%).Conclusions The public still fails to know enough about radiation and nuclear power.Although they trust the government,they are dissatisfied with the performance of the local government in dealing with the incident.The negative evaluation of the students is worth concerning.

Objective The objective of this study is to evaluate the levels of serum parathyroid hormone in Yangjiang where residents suffered long-term exposure to low levels of ionizing radiation.Methods Blood samples were collected from healthy male residents aged 40～65 who lived in Tangkou,Yangix(the highest dose rate areas in Yangjiang),Hengpi and Enping(control areas).Intact parathyroid hormone(iPTH) was tested by the method of enzyme-linked immunosorbent assay(ELISA).Results The model of multiple regression analysis showed a negative correlation between the levels of serum parathyroid hormone concentration and individual cumulative dose(P0.05).The mathematic formula is:PTH=-9.81*dose+4.53.Conclusion Long-term low-dose radiation exposure may affect the parathyroid hormone levels.

目的 介绍ESOREX项目,对欧盟个人监测现状进行分析.方法 对ESOREX项目的 报告和数据进行汇总分析,并结合IAEA<外部辐射源引起的职业照射评估>(No.RS-G-1.3)等安全标准和相关文献进行讨论.结果 欧洲大部分国家个人监测工作集中程度高.TLD剂量计在监测中得到广泛使用.电子直读式个人剂量计在某些特殊岗位得到普遍使用.大多数国家使用Hp(10)、np(0.07)作为外照射操作量,对于记录水平监管部门通常给出定值,并且作为最低探测水平(MDL)的官方规定取值.对于使用铅围裙时剂量计的佩戴方式、监测中是否扣除本底,各国处理有差别.结论 欧洲各国普遍建立了国家级的个人监测数据库,通过有效连续的保持个人监测记录,为辐射防护工作提供有效的支持.

Purpose To develop a national registry and reporting system of individual monitoring for workers occupationally exposed to ionizing radiation.Methods In accordance with the relevant law,regulations,standards and the current health supervision practice for radiation workers in China,to ensure more effective collection of information on individual monitoring from all levels of service providers across the country and an easy query and analysis of the collected information for both service providers and administrative institutions,the register consisted of an offline-system and a web-based information system.The off-line system consisted of 8 tables,which could easily make annual and period monitoring reports,and upload individual monitoring data in compressed and encrypted format.Web-based system consisted of 6 modules,could easily make S customized tabulations of monitoring data and show 2 trend figures.SSLVPN secure remote access was used in the system.Arranged by the Ministry of Health,training courses provided to all individual monitoring service providers and provincial administrative institutions.Results A new and individual-based national register and reporting system of individual monitoring for workers occupationally exposed to ionizing radiation was successfully developed,and would be officially run soon.Conclusions The establishment and running of the register would be great improvement on the national radiological health reports and produce a far-reaching impact on the individual monitoring in China.