某市毗邻核电站地区2015～2017年围生儿出生缺陷现状分析

目的 调查并分析广东大亚湾核电站运行后周围50 km惠州辖区内环境γ辐射水平和围生儿出生缺陷的发生情况。 方法 以广东大亚湾核电站1号机组为圆心，按半径范围分为0~20 km、20~30 km、30~40 km、40~50 km（各区间不含下界）等4个环形调查区。收集2015~2017年各调查区内环境γ辐射的累积剂量和围生儿出生缺陷资料，分析不同年份、不同距离的出生缺陷发生率及其顺位。采用方差分析比较不同距离内环境γ辐射累积剂量之间的差异，采用χ2检验对不同年份、不同距离出生缺陷率的差异进行比较。 结果 2015~2017年环境γ辐射年累积剂量为（2.00±0.20） mSv，各调查区之间的差异均无统计学意义。收集到围生儿58 999名，有出生缺陷的患儿691例，出生缺陷总发生率为117.12/万。不同年份的出生缺陷发生率不同，2015年最低（74.86/万），2017年最高（139.92/万），各年之间的差异有统计学意义（χ2=35.807，P=0.000）。不同距离的各调查区的出生缺陷发生率不同，40~50 km的出生缺陷率最高（158.81/万），30~40 km的出生缺陷率最低（80.56/万），各调查区之间的差异有统计学意义（χ2=63.622，P=0.000）。出生缺陷前5位的疾病依次为多指（114例）、先天性心脏病（102例）、葡萄糖-6-磷酸脱氢酶缺乏症（75例）、马蹄内翻足（31例）和胎儿水肿综合症（23例）。 结论 调查区域环境γ辐射水平较稳定，围生儿出生缺陷发生率在广东省内处于一般水平，出生缺陷发生率和顺位的变动属于自然变动。

Birth defects among perinatal infants in a city near Daya Bay Nuclear Power Station from 2015 to 2017

Objective To survey and analyze the environmental gamma radiation level and the status of birth defects among perinatal infants in Huizhou within 50 km away from the Guangdong Daya Bay Nuclear Power Station(GNPS). Methods Unit 1 of GNPS was taken as the center of the circle and divided into four circular investigation areas with radii of 0–20 km, 20–30 km, 30–40 km, and 40 –50 km(each interval excluded the lower boundary). Data on the accumulated doses of environmental gamma radiation and the status of birth defects among perinatal infants in each investigation area from 2015 to 2017 were collected, and the birth defect rate of perinatal infants and the top five birth defects in Huizhou among different years and within different ranges around GNPS were analyzed. Analysis of variance was used to compare the differences in accumulated dose of the environmental gamma radiation among various distances, and Chi-square test was used to compare the differences in birth defect rate among various years and various distances. Results The annual accumulated dose of environmental gamma radiation was(2.00±0.20) mSv from 2015 to 2017 and did not vary among different investigation areas. Out of the 58,999 perinatal infants, 691 were born with birth defects. The total incidence of birth defects was 11712 per million. The incidence of birth defects varied from year to year. Specifically, the lowest rate was found in 2015(7486 per million), whereas the highest rate was observed in 2017(13992 per million). Significant difference in birth defect rate was observed among different years(χ2=35.807, P=0.000). The incidence of birth defects was different among various investigation areas within the distance from the nuclear power plant. In particular, the highest birth defect rate was found at 40 –50 km(15881 per million), whereas the lowest birth defect rate was observed at 30 –40 km(8056 per million). Significant differences in birth defect rate was also observed among the investigation areas(χ2=63.622, P=0.000). The top five detected birth defects were polydactyly(114 cases), congenital heart defects(102 cases), glucose-6-phosphate dehydrogenase deficiency(75 cases), talipes equinovarus(31 cases), and hydrops fetalis syndrome(23 cases). Conclusions Within 50 km around GNPS, the environmental gamma radiation level and the birth defect rate were stable and consistent with the average level in Guangdong. Moreover, the changes in birth defect rate and sequence were spontaneous.