首页|2023年贵州省5 870例放射工作人员血细胞计数主要参数分析

2023年贵州省5 870例放射工作人员血细胞计数主要参数分析

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目的 了解低剂量电离辐射对放射工作人员主要血细胞计数参数的影响,为放射工作人员健康监护及风险评估提供参考依据.方法 对2023年在贵州省接受职业健康检查的5 870名放射工作人员血细胞计数结果按不同年龄、接害工龄、工种进行分析.结果 接触组血小板数量(platelet count,PLT)[(240.06±59.09)x109/L]显著高于对照组[(236.36±58.01)x109/L],差异有统计学意义(P<0.05).平均血小板体积(mean platelet volume,MPV)接触组为(11.04±1.48 fl),对照组为(10.88±1.42)fl,差异有统计学意义(P<0.05).血小板比容(platelet crit,PCT)接触组为(0.26±0.05)%,对照组为(0.25±0.05)%,差异有统计学意义(P<0.05).血小板分布宽度(platelet distribution width,PDW)接触组为(15.35±2.19)fl,对照组为(15.20±2.35)fl,差异有统计学意义(P<0.05).大血小板比例(platelet large cell ratio,P-LCR)接触组为(33.21±9.99)%,对照组为(32.06±9.63)%,差异有统计学意义(P<0.05).男性红细胞计数(red blood cell,RBC)接触组为(5.40±0.45)×1012/L,对照组为(5.34±0.48)×1012/L,差异有统计学意义(P<0.05).白细胞计数(white blood cell,WBC)、血红蛋白(hemoglobin,HB)及女性RBC计数在两组间差异均无统计学意义(均P>0.05).随着工龄增加,WBC计数、MPV、P-LCR呈上升趋势;与岗前组比较,0~<10、10~<20、≥ 30年组差异均有统计学意义(均P<0.05);PCT、PLT计数、RBC计数随着工龄增加逐渐降低,各组间比较差异均有统计学意义(均P<0.05).不同工种间分析发现,与诊断放射学组相比,放射治疗组、介入放射学组与牙科放射学组WBC计数、PLT、MPV、PCT、PDW、P-LCR均降低,差异均有统计学意义(均P<0.05).与放射治疗组相比,介入放射学组与牙科放射学组PLT、MPV、P-LCR、男性RBC计数均降低,核医学组MPV、P-LCR均降低,差异均有统计学意义(均P<0.05);与介入放射学组相比,牙科放射学组男性RBC计数降低,差异有统计学意义(P<0.05).结论 人体长期暴露于低剂量辐射环境中会导致血细胞计数WBC、MPV、PCT、PDW、P-LCR、RBC发生变化.在进行放射工作人员健康监护时,应关注此类指标的改变,进一步改善放射工作人员的职业健康.
Analysis of the main parameters of blood cell counts of 5 870 cases of radiation workers in Guizhou Province in 2023
Objective To investigate the effects of low-dose ionizing radiation on the main blood count parameters of radiation workers,and provide reference basis for health monitoring and risk assessment of radiation workers.Methods The results of blood cell counts of 5 870 radiation workers who underwent occupational health examination in Guizhou Province in 2023 were statistically analyzed according to different ages,different years of exposure to hazards,and different types of work.Results The platelet count(PLT)of the exposed group[(240.06±59.09)×109/L]was significantly higher than that of the control group[(236.36±58.01)×109/L],with a statistically significant difference(P<0.05).The mean platelet volume(MPV)in the exposed group was(11.04±1.48)fl,compared to(10.88±1.42)fl in the control group,with a statistically significant difference(P<0.05).The platelet crit(PCT)in the exposed group was(0.26±0.05)%,versus(0.25±0.05)%in the control group,showing a statistically significant difference(P<0.05).The platelet distribution width(PDW)in the exposed group was(15.35±2.19)fl,while it was(15.20±2.35)fl in the control group,with a statistically significant difference(P<0.05).The platelet large cell ratio(P-LCR)in the exposed group was(33.21±9.99)%,compared to(32.06±9.63)%in the control group,also showing a statistically significant difference(P<0.05).The red blood cell count(RBC)of males in the exposed group was(5.40±0.45)×1012/L,while in the exposed group it was(5.34±0.48)×1012/L,with a statistically significant difference(P<0.05).However,there were no statistically significant differences in white blood cell count(WBC),hemoglobin(HB),and female RBC count between the two groups(all P>0.05).As the length of service increased,WBC count,MPV,and P-LCR showed an upward trend.Compared with the pre-post group,there were statistically significant differences between the 0-<10,10-<20,and ≥30 year groups(all P<0.05).PCT,PLT counts,and RBC counts decreased progressively with increasing years of service,and the differences between the groups were statistically significant(all P<0.05).Analysis among different types of work revealed that WBC count,PLT,MPV,PCT,PDW,and P-LCR were decreased in the radiation therapy group,interventional radiology group,and dental radiology group compared with the diagnostic radiology group(all P<0.05).Compared with the radiation therapy group,PLT,MPV,P-LCR,and male RBC counts were all reduced in the interventional radiology group and the dental radiology group,MPV and P-LCR were reduced in the nuclear medicine group(all P<0.05).Compared with the interventional radiology group,the dental radiology group showed a statistically significant decrease in male RBC counts(P<0.05).Conclusion Prolonged exposure to low doses of radiation causes changes in blood cell counts WBC,MPV,PCT,PDW,P-LCR,RBC.When conducting health monitoring for radiation workers,attention should be paid to changes in such indicators to further improve their occupational health.

Ionizing radiationRadiation workersBlood routineLow doseParameter analysisGuizhou Province

陈友虹、李佐祥、李玲、李燚、侯腾

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贵州省第三人民医院检验科,贵州 贵阳 550008

电离辐射 放射工作人员 血常规 低剂量 参数分析 贵州省

2024

职业与健康
天津市疾病预防控制中心 中华预防医学会

职业与健康

CSTPCD
影响因子:0.737
ISSN:1004-1257
年,卷(期):2024.40(23)