中国医用诊断X射线工作者肿瘤效应队列研究预调查实施分析及建议

目的 对重庆市6个区县开展的中国医用诊断X射线工作者肿瘤效应队列研究项目进行预调查与分析,为在全国范围内开展调查积累经验。 方法 以1995年随访调查的名单为依据,选取1950年至1980年于重庆市6个区县医院工作的126名医务人员作为调查对象,65名从事过放射工作的医务人员作为放射组,其中男性54名、女性11名;61名未从事过放射工作的医务人员作为对照组,其中男性54名、女性7名。核实1995年随访调查信息,采用回顾性和前瞻性队列相结合的方法查清队列成员新发的恶性肿瘤情况、死亡原因和从事放射工作的变化情况等信息。组间计数资料的比较采用χ2检验;计量资料的比较采用Student t检验,均采用双侧检验。 结果 预调查结果显示,共有95名队列成员完成了随访,其中放射组59名、对照组36名。1950年至2019年期间患肿瘤的患者共18例,其中放射组13例、对照组5例。因肿瘤死亡的患者15例,其中放射组10例、对照组5例。队列成员共死亡33名,失访31名,失访率为24.6%（31/126）。对照组的失访率高达41.0%（25/61）,高于放射组（9.2%,6/65）,2组间的差异有统计学意义（χ2=17.104, P<0.001）。预调查中队列成员姓名错误率20.0%（19/95）,出生年份错误率78.9%（75/95）。预调查中还存在问卷填写不完整等问题。 结论 预调查为在全国开展X射线工作者肿瘤效应队列研究提供了可供参考的解决方案,如补充混杂因素调查、利用各地区资源开展工作、建立在线填报系统等。

Implementation analysis and suggestions on the pre-survey of the study of Chinese medical diagnostic X-ray workers tumor effect cohort

Objective To provide valuable experience for the nationwide surveys through the pre-survey and implementation analysis of the Chinese medical diagnostic X-ray workers' tumor effect cohort research project carried out in 6 districts of Chongqing. Methods Based on the list of follow-up surveys in 1995, 126 medical staff who worked in 6 district and county hospitals in Chongqing from 1950 to 1980 were selected as the survey subjects, and 65 medical staff who had been engaged in radiation work were selected as the radiation group, including 54 males and 11 females; medical staff in internal medicine, surgery, otorhinolaryngology and 61 medical staff who haven't engaged in radiation work were used as the control group, including 54 males and 7 females. The information of previous surveys was in 1995 verified, a combination of retrospective and prospective cohort methods was used to identify malignancies, causes of death, and changes in radiation work among cohorts. The comparison of enumeration data was performed by χ2 test, and the comparison of measurement data was performed by Studet's t test, both of which were two-sided. Results The pre-survey results show that a total of 95 team members have completed follow-up, including 59 cases in the radiation group, 36 cases in the radiation group. During the period 1950?2019 a total of 18 cases with tumors, including 13 cases in the radiation group, 5 cases in the control group. In 15 cases of tumor death, 10 cases in the radiation group and 5 cases in the control group. A total of 33 cases were dead, 31 cases were lost, and the rate of loss of follow-up was 24.6% (31/126). The rate of loss of follow-up in the control group was as high as 41.0% (25/61), was higher than in the radiation group (9.2%, 6/65), and the difference between the two groups was statistically significant (χ2=17.104, P<0.001). In the pre-survey, the error rate of names of team members in pre-survey was 20.0% (19/95) and year of birth error rate 78.9% (75/79), and there is still a problem that the lack of completeness of the questionnaires. Conclusion It provides a reference solution for the national X-ray worker tumor effect cohort study, such as supplementing confounding factors investigation, using resources from various regions to carry out work, establishing an online reporting system, etc.