2014—2021年四川省从事放射性工作人员淋巴细胞微核率分析

目的 分析2014—2021年四川省放射性职业健康体检中从事放射性工作人员的外周血淋巴细胞微核率情况，为今后职业健康防护提供依据。方法 收集2014—2021年从事放射工作人员的健康体检资料为放射组，相应年份的非放射工作人群为对照组，对其外周血淋巴细胞微核率进行分析，并对异常增高者（＞4‰）的暴露工龄、工种及停止暴露年限采用t检验、u检验、方差检验及χ2检验等检验方法进行比较。结果 放射组与对照组外周血淋巴细胞微核率总体分布差异有统计学意义（u = 2.348，P = 0.019），放射组2014—2019年外周血淋巴细胞微核率均值有缓慢下降趋势，2020—2021年有较明显增高（2020—2019年间k - w检验h = 3.961，P = 0.002），而对照组呈波动性呈不规则变化；各年度放射组异常增高人数占比与对照组异常增高人数占比差异均有统计学意义（合计值χ2 = 51.425，P＜0.001）；而根据工种的不同，放射医学组与非放射医学组微核率差异有统计学意义（χ2 = 194.524，P＜0.001），核医学组与放射治疗组微核率差异有统计学意义（χ2 = 47.778，P＜0.001），介入治疗组与放射治疗组微核率差异有统计学意义（χ2 = 25.565，P＜0.001）；涉核部队暴露工龄接近，停止暴露年限小于10年和大于40年异常增高所占比例分别与另外4个区间之和差异有统计学意义（χ2 = 17.146，P＜0.001；χ2 = 6.977，P = 0.008）。结论 四川省从放人员微核异常率近两年呈增高趋势，特别是介入治疗和核医学工作人员的占比明显，建议加强放射工作人员的健康防护。

Analysis of lymphocyte micronucleus rate of radiation workers in Sichuan Province from 2014 to 2021

Objective To analyze the micronucleus rate in peripheral blood of workers engaged in radioactive occupational health examination from 2014 to 2021, and to provide basis for future occupational health protection. Methods The health examination data of the personnel engaged in radiation from 2014 to 2021 were collected as the radiation group, and the non-radiological workers in the corresponding year were collected as control group. The micronucleus rate of peripheral blood lymphocytes was analyzed. The exposure length of service, working age, type of work and year of exposure cessation of those with abnormal increase (>4‰) were compared using t test, u test, variance test, and χ2 test, respectively. Results The difference in peripheral hemolymocyte micronucleus rates between the radiation group and the control group was statistically significant (u=2.348, P=0.019), and the rate of peripheral hemolypolytic micronucleus in the radiation group from 2014 to 2019 showed a slow downtrend, and a significant increase in 2020 to 2021 (k-w test between 2020 and 2019: h=3.961, P=0.002), while the control group showed fluctuating irregular changes. The proportion of abnormal increases in the radiological group between years was statistically significant (χ2=51.425, P<0.001). According to different types of work, the difference of micronucleus rate between radiation medicine group and non-radiation medicine group was statistically significant (χ2=194.524, P<0.001), that between nuclear medicine group and radiotherapy group was statistically significant (χ2=47.778, P<0.001), and that between interventional therapy group and radiotherapy group was statistically significant (χ2=25.565, P<0.001). The exposure length of service of nuclear forces was close, and the proportion of abnormal increase of stopping exposure for less than 10 years and more than 40 years was statistically significant compared with the sum of the other four intervals (χ2=17.146, P<0.001; χ2=6.977, P=0.008, respectively). Conclusion The rate of micronucleus abnormalities among radiation workers in Sichuan Province has been increasing in the past two years, especially the proportion of interventional and nuclear medicine workers is obvious, and it is recommended to strengthen the health protection of radiation workers.