A retrospective analysis of occupational exposure to ionizing radiation from medical uses and industrial uses in the three provinces of Central China from 2000 to 2021 was conducted. The average annual effective dose in medical uses and industrial uses decreased from 2.042 mSv and 2.334 mSv in 2000–2002 to 0.476 mSv and 0.371 mSv in 2021 respectively; the fraction of monitored workers receiving annual dose not exceeding 1 mSv increased from 60.78% and 74.45% in 2000–2002 to 94.20% and 96.85% in 2021 respectively, while receiving annual doses exceeding 20 mSv declined from 1.35% and 1.91% in 2000–2002 to 0.18% and 0.03% in 2021 respectively. The average annual effective dose and NR20 in the period 2000–2021 were relatively high in professional public health institutions (0.955 mSv and 0.004) and hospitals (0.815 mSv and 0.004). In 2021, the average annual effective dose to monitored workers in different occupational categories in medical uses in the three provinces of Central China were in the range of 0.199–0.692 mSv, with interventional radiology received the highest dose and NR20 (0.692 mSv and 0.005); the average annual effective dose ranged from 0.161 to 0.493 mSv in industrial uses, with industrial radiography received the highest dose and NR20 (0.493 mSv and 0.001). Occupational exposure in medical uses and industrial uses declined obviously in Central China, and the groups receiving higher doses are the radiation workers working in hospitals and professional public health institutions, or engaged in interventional radiology, nuclear medicine and industrial radiography, warranting more effective radiation protection measures.

Objective:To analyze the current situation of diagnostic radiology equipment in Chinese mainland and to un-derstand changes in the past 20 years,including gaps with other countries,in order to provide a scientific basis for the government to formulate relevant policies and regulations,and supplement Chinese data for international organizations. Methods:This survey adopted a uniformly designed questionnaire,which was completed by the investigators or the respondents.The survey was distributed to all medical institutions that provided diagnostic radiology services in 31 provinces,autonomous regions,and municipalities,excluding Hong Kong,Macao,Taiwan,and military,China. Results:The survey showed that in the past 20 years,the number of medical institutions and diagnostic radiology equipment per million population in China has increased substantially.Dental radiology equipment increased nine-fold,and mammography equipment and computed tomography scanners showed a nearly five-fold increase.The four types of diagnostic radiology equipment,general diagnostic,fluoroscopic,mammography,and computed tomography,were associated with the population.Dental radiology equipment and bone mineral densitometers were related only to the gross domestic product(GDP).A large gap remains in the diagnostic radiology equipment per million population between China and the equipment of health-care level(HCL)I countries. Conclusions:An imbalance in the number of units of diagnostic radiology equipment per million population was observed in the different regions,China.Various types of diagnostic radiology equipment,especially mammog-raphy equipment and computed tomography scanners,need to be deployed to meet the medical needs of different populations.

Abstract The eye lens is a sensitive tissue to ionizing radiation and recently has been recognized as more radiosensitive than previously considered. The International Commission on Radiological Protection (ICRP) has recommended a considerable reduction in the equivalent dose limit of eye lens from 150 mSv y−1 to 20 mSv y−1, averaged over a defined period of 5 y. In this paper, the eye lens dose of interventional radiology workers in China during 2017–2019 is analyzed to understand the current status of eye lens occupational exposure and to provide decision-making suggestions for health supervision departments using data obtained from the National Radiological Health Information Platform in China. A total of 3,026 eye lens dose records of interventional radiology workers were collected. The average annual eye lens dose (AAELD) for interventional radiology workers ranged from 1.07 to 1.51 mSv during 2017-2019 and was 1.44 mSv for all monitored interventional radiology workers, with 2,973 records (98.2%) lower than the public limit of 15 mSv and 33 records (1.1%) exceeding the newly revised occupational eye lens dose limit of 20 mSv y−1. During the period of 2017-2019, the AAELDs of interventional radiologists (1.61 mSv) and of interventional cardiologists (1.59 mSv) were significantly higher than that of other interventional workers (0.62 mSv); the AAELD of doctors (1.50 mSv) was significantly higher than that of nurses (1.01 mSv); the AAELD of western China (2.00 mSv) was significantly higher than that of eastern (1.11 mSv) and central China (1.27 mSv); and the AAELD of males (1.59 mSv) was significantly higher than that of females (0.84 mSv). The eye lens dose of interventional radiology workers meets the Chinese standard limit of 150 mSv y−1, while some cases exceed the one recommended by ICRP. The study shows that the interventional radiology workers’ eye lens dosimetry data complied with the existing Chinese eye lens dose limits. However, education, training, and supervision of radiation protection also should be strengthened continuously for interventional radiology workers, especially for the interventional radiologists and interventional cardiologists. Significant attention should be paid to the radiation protection of underdeveloped regions in China in future works.

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.

Objective: To grasp the occupational health monitoring of radiation workers in medical institutions across the country, and to discover weak links in the prevention and treatment of occupational radiation diseases. Methods: In 2020 January, according to the monitoring data of the "National Radiation Health Information Platform" (Occupational Radiation Disease and Occupational Health Monitoring Subsystem and Occupational Radiation Disease Reporting Subsystem) , the national occupational health monitoring data from January 1 to December 31, 2019, including the number of radiation workers in medical institutions, occupational health examinations, personal dose monitoring and occupational radiation disease diagnosis, were descriptive analyzed. Results: There were a total of 394436 radiation workers in medical institutions across the country. The number of radiation workers in various provinces was quite different, with a median of 10206, which was positively correlated with the number of permanent residents in each province (r=0.947) . There were 376 personal dose monitoring institutions nationwide, and the personal dose monitoring rate of radiation workers in medical institutions was 96.61% (381045/394436) . There were 419 occupational health inspection institutions for radiation workers across the country, and 269 (64.20%) used software to print physical examination forms. A total of 334455 radiation workers in medical institutions had been subjected to occupational health examinations. The rate of occupational health examinations for radiation workers in medical institutions was 84.79% (334455/394436) . The abnormal rate of chromosomal aberrations in peripheral blood lymphocytes of radiation workers in medical institutions was 0.33% (776/233571) , the detection rate of posterior posterior subcapsular turbidity was 0.63% (2093/334455) , and the abnormality rate of thyroid color ultrasound was 28.49% (14946/52464) . In 2019, a total of 16 cases of occupational radiation diseases were reported. Conclusion: The personal dose monitoring rate and occupational health examination rate of medical radiation workers nationwide are relatively high, but the quality of lymphocyte chromosome aberration analysis, eye lens examination and thyroid color photograph examination needs to be further improved.

Objective:To analyze the dose range distribution of abnormal result, the distribution of occupational categories, the incidence of abnormal result of different occupational categories, the causes of abnormal result and the factors influencing abnormal values, on the basis of investigated abnormal result of individual monitoring for occupationally external exposure, in order to provide the scientific basis for the formulation of the relevant regulations and standards and the hospital radiation protection management.Methods:The abnormal result of 389 radiation workers in medical institutions receiving annual individual doses each exceeding 1.25 mSv, reported in 2017 in 19 provinces, were collected and analyzed.Results:Dose distribution range of abnormal result were mainly between 1.25 and 5 mSv; diagnostic radiology workers accounted for the highest fraction, 59.64% of the totals; and interventional radiology workers had the highest incidence, 4.17‰ of abnormal result. The abnormal result was mainly caused by improper wearing or operating personal dosimeters; the abnormal values in the eastern regions were higher than those in other regions, with a median of 6.41 mSv; the abnormal values in the cause-unknown group was higher than those in other groups, with a median of 10.32 mSv.Conclusions:The publicity and training of radiation protection knowledge should be further strengthened to improve the protection awareness of radiation workers. The occupational exposure of interventional radiology workers should receive special attention.

Objective:To investigate the allocation of radiation protection equipment and status of radiological protection management for radiation workers in hospitals nationwide.Methods:A descriptive analysis was conducted of the data reported from the investigated hospitals based the data for 2019 available from the National Radiological Health Information Platform.Results:A total of 3 806 hospitals were investigated in 2019, including 609 tertiary hospitals, 1 421 secondary hospitals, 1 776 primary and ungraded hospitals. Large differences had been shown in the number of radiation workers in different grade hospitals. The average number of radiation workers were found to be, respectively, 99 in tertiary hospitals, 19 in secondary hospitals, 2 in primary and/or ungraded hospitals. Interventional radiology and nuclear medicine workers were equipped seperately with 0.40 and 0.43 pieces of lead apron, 0.27 and 0.31 lead caps, 0.38 and 0.45 lead rubber neck sleeves, 0.18 and 0.08 pairs of lead rubber gloves and 0.31 and 0.22 pairs of lead glasses. No personal alarming dosimeter was available in 15.25% hospitals where radiotherapy was performed, nor radiation surveillance meter in 27.90% such hospitals. In the hospitals considered, 88.13% workers were granted the Radiation Worker Cetificate and 83.69% received the on-the-job radiation protection training. The number of monitored workers accounted for 99.20%, of which 0.40% received the personal annual dose Hp(10)≥20 mSv. The occupational health surveillance files that had been completed reached 98.05% of the total and the on-the-job radiation workers who had passed the occupational health examination made up to 96.00%. It was advised that, of 76 627 radiation workers who received the 2019 health examination, 0.88% should get out of radiation work for the being time and 0.11% should not continue for this work. Conclusions:The considerably large proportion of radiation workers in China have received individual dose monitoring and occupational health examination. Radiological diagnosis and therapy departments should enlarge the allocation of radiation monitoring and personal protection equipment for radiaton workers in their hospitals.

目的 分析2018年全国医疗机构放射工作人员职业健康监测结果.方法 通过"全国放射卫生信息平台"子系统"职业性放射性疾病与职业健康监测系统"收集2018年全国各省、自治区、直辖市放射诊疗机构概况、职业健康管理情况、职业健康检查信息等监测数据进行分析.结果 2018年全国共有55 902家放射诊疗机构,353 141名放射工作人员;全国和监测医院的个人剂量监测率分别为94.6％(334 222/353 141)和97.3％(91 051/93 559),职业健康检查率分别为84.6％(298 914/353 141)和95.4％(87 031/91 244);放射工作人员周围血淋巴细胞染色体畸变人员检出率为0.3％,介入放射学和核医学工作人员眼晶状体后囊下混浊率为4.3％,甲状腺结节检出率为25.7％.结论 我国医疗机构放射工作人员个人剂量监测率和职业健康检查率均保持在较高水平;但仍应高度关注周围血淋巴细胞染色体畸变分析、眼晶状体及甲状腺的检查.

目的 对数字化X射线摄影系统调试机房外周围剂量当量率及机房内辐射剂量进行检测,掌握调试机房外辐射水平及机房内的剂量分布情况,为做好调试工程师的防护最优化以及为机房的辐射防护设计提供参考.方法 参照《医用X射线诊断放射防护要求》(GBZ130-2013)对机房外辐射水平进行检测,使用热释光剂量计对机房内剂量分布进行检测.结果 该企业数字化X射线摄影系统调试机房外辐射水平和调试工程师的个人剂量监测结果符合国家标准要求,机房内的辐射剂量在距离模体表面100cm位置的剂量值均接近或超过1mSv.结论 加强数字化X射线摄影系统调试机房辐射防护的企业管理和政府监管,进一步优化辐射防护,可有效降低调试工程师受照水平.

目的:对医用X射线诊断设备生产企业的调试机房周围辐射水平进行检测,分析个别点位剂量率水平较高的原因,制定解决方案,以提高调试机房的辐射防护水平.方法:参照国家标准《医用X射线诊断放射防护要求》对北京地区具有代表性的医用X射线诊疗设备生产企业的医用X射线诊断设备调试机房周围辐射水平进行检测,对调试工程师的个人剂量进行监测,掌握调试机房外辐射水平和调试工程师的辐射防护情况.结果:检测的企业医用X射线诊断设备调试机房外辐射水平和调试工程师的个人剂量监测结果均符合国家标准的要求.结论:加强医用X射线诊断设备调试机房辐射防护的企业管理和政府监管,可有效降低调试机房周围辐射水平,并为做好调试工程师的辐射防护提供参考.

Objective To construct a national radiological health information platform, in order to collect and analyze radiological health monitoring and survey data, so as to improve data utilization and ensuring technology support to radiological health. Methods In accordance with China′s relevant laws, regulations and regulations, a national radiological health information platform was designed, developed and operated in response to the needs of radiological health monitoring, scientific research and management. Results The system was initially established in 2015, consisting of five business modules: medical radiation protection, personal dose, occupational health, food radioactivity monitoring and occupational radiological disease reporting. In the past 4 years, the system has been running normally and 5 business databases have been established. More than 8 million data of monitoring and survey have been collected. More than 1400 terminal users have good experiences and frequent interactions. Conclusions The successful construction of the national radiological health information platform not only promotes and standardizes the network direct reporting of radiological health monitoring and investigation business data, but also provides analytical and utilization tools for technical institutions/ personnel on radiological health, and gradually becomes an important scientific basis and database for the development of radiological health laws, regulations and standards in China as well as for national health service.

目的 对2017年全国30个省、直辖市和自治区职业性放射性疾病监测工作考核评分的20项指标进行分析,为进一步优化全国职业性放射性疾病监测项目提供技术支持和参考.方法 依据《职业性放射性疾病监测与职业健康风险评估工作考核评分表》(2017),运用TOPSIS法与秩和比法加权模糊联合分析评价结果并确定各指标的综合排序.结果 TOPSIS法与秩和比法加权模糊联合分析显示制定方案、专人负责、剂量监测率和监测医院数量4项指标并列第一;染色体检查、健康检查系统、创新和亮点以及个人剂量监测机构按时上报数据4项指标排名最后四位.结论 TOPSISI法与秩和比法的模糊联合法客观准确地评价了2017年全国职业性放射性疾病监测工作20项指标的执行情况,明确了监测工作中的薄弱环节,为进一步优化全国职业性放射性疾病监测体系提供了科学依据.

Occupational exposure to ionizing radiation from medical practices in China has been collected for a 7 y period between 2010 and 2016 from roughly 220 individual monitoring service providers through the Chinese Registry of Radiation Workers. Statistical dose distributions and characteristic tendencies are presented based on the evaluation in terms of six occupational categories. A reduction can be seen in average annual effective dose for interventional radiology, nuclear medicine, diagnostic radiology, radiotherapy, dental radiology, and others by 52%, 47%, 46%, 34%, 69%, and 31%, respectively, for the 7 y period. More than 94.5% of radiation workers received annual doses less than the public dose limit (1 mSv) in 2016. Workers engaged in nuclear medicine and interventional radiology activities were found to receive relatively more dose than the other fields of practice. Diagnostic radiology makes the dominant contribution of 68% to the collective effective dose of 73,641.3 person mSv received by 211,613 radiation workers in medical practices in 2016. The observation of workers in medical practices receiving well below the recommended occupational dose limit (20 mSv) could be a result of an improvement in radiation protection practices in the medical field in China. However, it is still necessary to control and manage the workplace and radiation workers to avoid unnecessary exposures, in particular for the workers engaged in nuclear medicine and interventional radiology activities.

Objective To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China. Methods In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs. Results An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure. Conclusions Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.

Objective To analyze 20 indicators for the evaluation of medical radiation protection monitoring in 31 provinces,municipalities or autonomous regions in 2017 and provide technical support and reference for further optimization of medical radiation protection monitoring projects.Methods According to " medical radiation protection monitoring assessment score sheet for medical and health institutions",a full range of analysis and evaluation was carried out of medical radiation protection monitoring and implementation at nationwide medical and health institutions by using fuzzy combined method of TOPSIS and rank sum ratio.Results TOPSIS method and rank sum ratio weighted fuzzy joint analysis showed that the top three indicators,in descending order,were management of provincial implementation plans,management of project leaders in various cities and management of funds whereas the lowest three indicators were completion of radiotherapy equipment commissioning,innovation and highlights and tcoverage of radiotherapy equipment.Conclusions The fuzzy combined application of TOPSIS method and rank sum ratio method can provide the comprehensive quantitative result for the implementation of medical radiation protection monitoring in 2017,objectively evaluate the implementation of various indicators,summarize the highlights and bottlenecks of work in 2017,and provide technical support and reference for further optimization of medical radiation protection monitoring.

目的 分析2015-2017年我国部分放射诊疗机构放射工作人员的职业健康监测数据,为职业性放射性疾病的预防和控制提供科学依据.方法 通过“全国放射卫生信息平台-职业健康监测模块”采集近三年部分放射诊疗机构放射工作人员职业健康监测相关数据,并进行统计与分析.结果 2015-2017年监测医院放射工作人员个人剂量监测率分别为98.3％、98.9％、98.7％;职业健康检查率分别是95.5％、94.8％、95.7％.外周血淋巴细胞染色体畸变异常人员比例逐年降低分别为:0.9％、0.7％、0.3％;眼晶状体混浊率逐年降低分别为8.6％、7.7％、7.9％;甲状腺检查异常率逐年增加分别为18.8％、21.1％、22.1％.结论 总体上,我国放射诊疗机构放射工作人员的职业健康监护水平逐年提高,但眼晶状体和甲状腺的检查和防护仍需高度关注.

Objective To understand the dosimetric performance of energy differential type dosimeter.Methods A differential type dosimeter (CTLD-J4000) was chosed to conduct a series of dosimetric performance tests,including linear standard curves,relative response to mean photon radiation energy and incidence angle.Results The linear correlation of CTLD-J4000 energy differential dosimeter was good,with the average photon radiation energy response deviation within ± 20％ and the maximum incidence angle response deviation of 10％.The energy identification could be achieved according to the energy reference value provided by the manufacturer to a certain extent.Conclusions Further experiments are needed to find out the factors influencing measurement result from different dose values and incidence angles.

Analysis on the problems existing in the writing of the test reports of external individual dose monitoring in 2016 Hao Shuxia, Guo Wen, Hu Aiying, Ding Yanqiu Key Laboratory of Radiological Protection and Nuclear Emergency, China CDC, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088,China Corresponding author: Guo Wen,Email:guowen_cn@ 126. com