摘要
通过对我国部分省市近年来诊断的职业性放射性疾病诊断病例进行分析,以发现职业性放射性疾病诊断中存在的问题,并探讨其解决措施。收集2013—2020年我国部分地区职业性放射性疾病诊断的病例共计74人,对病历进行汇总分析;针对8省1系统(四川、江苏、内蒙古、山东、河南、天津、安徽、浙江和核工业系统)的140名诊断医师进行了标准知晓、标准宣贯和标准应用情况问卷调查。调查结果表明,2013年至2020年共诊断职业性放射性疾病病例74人、病例数共计83例,涉及有害的组织反应疾病(确定效应)35人、42例,发病数前3位是放射性白内障、放射性皮肤损伤和慢性放射病;涉及放射性肿瘤39人、41例,前3位依次是放射性甲状腺癌、放射性白血病和放射性肺癌;同时确诊为2种及以上职业性放射性疾病的8人。职业性放射性疾病诊断医师对标准知晓率76.2%,参加标准宣贯77%;标准应用情况,未使用及每年应用小于2次的为51.2%。通过调查了解了职业性放射性疾病现状,发现在职业性放射性疾病诊断中存在受照剂量高估、诊断标准知晓和使用率低等问题。
Through case analysis on occupational radiation-induced diseases diagnosed in recent years in some provinces and cities in China,this study identifies issues in the diagnosis of occupational radiation-induced diseases and explores solutions.A total of 45 cases were collected from Sichuan,Jiangsu,Inner Mongolia,Shandong,Henan,Tianjin,Anhui,Zhejiang,and the nuclear industry system(8 provinces and 1 system).Additionally,29 cases were collected from other provinces or provinces that did not report to the system,resulting in a total of 74 cases.The medical records were aggregated and analyzed.A questionnaire survey was conducted among 140 diagnostic physicians from 8 provinces and 1 secction to assess their awareness of standards,participation in standard dissemination,and application of standards.From 2013 to 2020,a total of 74 individuals were diagnosed with occupational radiation-induced diseases,involving 83 cases.Among these,35 individuals(42 cases)were diagnosed with harmful tissue reactions(deterministic effects),with the top three diseases being radiation-induced cataracts,radiation-induced skin injuries,and chronic radiation sickness.Additionally,39 individuals(41 cases)were diagnosed with radiation-induced tumors,with the top three being radiation-induced thyroid cancer,radiation-induced leukemia,and radiation-induced lung cancer.Eight individuals were diagnosed with two or more types of occupational radiation-induced diseases.The awareness rate of diagnostic standards among physicians was 76.2%,and 77%of physicians participated in standard dissemination activities.Regarding standard application,51.2%of physicians reported not using the standards or using them fewer than two times per year.The analysis reveals that in the diagnosis of occupational radiation-induced diseases,there are issues such as overestimation of radiation doses and low awareness and usage rates of diagnostic standards.Understanding the current status of occupational radiation-induced diseases is essential to address these challenges.
作者
于程程
余智平
邢志伟
赵风玲
YU Chengcheng;YU Zhiping;XING Zhiwei;ZHAO Fengling(Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine,Institute of Radiation Medicine,Chinese Academy of Medical Sciences and Peking Union Medical College,Tianjin 300192;Daya Bay Nuclear Power Operation and Management Corporation Ltd.,Guangdong Shenzhen 518124;The Third People’s Hospital of Henan Province(Henan Occupational Disease Hospital),Zhengzhou 450052)
出处
《辐射防护》
北大核心
2025年第5期459-465,共7页
Radiation Protection
基金
国家卫生健康委法规司常见职业性放射性疾病诊断标准实施评估(20202105)。
关键词
职业性放射性疾病
标准评估
问卷调查
病例分析
occupational radiation sickness
standard assessment
questionnaire survey
case analysis
作者简介
于程程(1987-),女,2010年本科毕业于成都中医药大学中西医结合临床专业,2013年硕士毕业于北京协和医学院放射医学专业,副研究员。E-mail:yuchengcheng@irm-cams.ac.cn;通信作者:邢志伟。E-mail:xing_1964@163.com。
