山东省放射工作人员五年外周血细胞计数与细胞遗传指标比较分析

目的 通过调查山东省放射工作人员血常规中白细胞、血红蛋白、血小板计数的平均值，外周血淋巴细胞染色体畸变率和微核率，掌握山东省放射工作人员职业健康现状，探讨低剂量电离辐射对放射工作人员健康的影响。方法 采用整体随机抽样法，对2013年-2017年期间进行职业健康检查的1 2496名放射工作人员血常规中白细胞、血红蛋白、血小板计数的平均值、外周血淋巴细胞染色体畸变率和微核率进行分析。结果 2013年-2017年期间，山东省放射工作人员血常规中白细胞、血红蛋白、血小板计数的平均值及外周血染色体畸变率的年度差异有统计学意义，但未观察到规律性变化，而微核率有呈逐年降低趋势（χ²=28.000，P < 0.05）。不同工种间比较，影像诊断组和X射线工业应用组血常规中白细胞、血红蛋白、血小板计数的平均值差异较大，其中白细胞平均值以探伤组最高，影像组次之，放疗组最低；血红蛋白平均值以工业辐照组最高，牙科组最低；血小板平均值以工业测井组最高，工业探伤最低。外周血淋巴细胞染色体畸变率和微核率分别以工业探伤组和工业辐照组最高，且都以牙科组最低。随工龄的延长，放射工作人员白细胞和血红蛋白平均值略有升高趋势，血小板均值略有下降趋势。微核率除岗前组相对较低外，在岗工作人员微核率随工龄变化趋势不明显。不同工龄水平，染色体畸变率未有统计学意义（χ²=0.209，P>0.05）。结论 长期低剂量电离辐射可使机体受到一定的辐射损伤，其中放疗、介入和工业应用领域的放射工作人员是放射防护宣传和监督的重点人群。

Five-year analysis of peripheral blood cell count average and chromosomal aberration and micronucleus rate ofperipheral blood lymphocytes of radiation workers in ShanDong Province

Objective To analyze the average number of white blood cells, hemoglobin, and platelet counts in the blood routine of radiation workers in Shandong Province, the occupational health status of radiation workers, to discuss the effect of low-dose ionizing radiation on the health of radiation workers. Methods Use the overall random sampling method to analyze the blood routine, chromosome aberration rate and micronucleus rate of the 12 496 radiation workers, who performed occupational health examination between 2013 and 2017. Results The annual difference between blood routine and chromosomal aberration was significant from 2013 to 2017. The rate of micronucleus shows a gradual decrease trend (χ²=28.000, P<0.05). The difference between blood routine in the Imaging-diagnosis group and the X-ray industrial group was signifigant, and the chromosomal aberration and the rate of micronucleus was higher than that of the other groups. The difference is statistically significant. compared between different types of works. The average of white blood cells and hemoglobin gradually increased as the length of service increases. The average changes in platelets are statistically significant, There was no significant difference in chromosomal aberration between different seniority groups. (χ²=0.209, P<0.05). Conclusion Long-term low-dose radiation exposition may cause a certain radiant injuries. radiotherapy group、interventional group and industrial group are the focus of radiation protection propaganda and supervision.