暴露于低剂量电离辐射的医护人员和学生的甲状腺参数变化。

IF 0.4 Q3 Medicine Giornale italiano di medicina del lavoro ed ergonomia Pub Date : 2022-09-01
Sabina Sernia, Andrea Bongiovanni, Andrea De Giorgi, Arturo Cafolla, Simone De Sio, Giuseppe La Torre
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引用次数: 0

摘要

摘要:背景。电离辐射(IR)是一个重要的职业风险因素,因为它可能对工人的健康造成潜在损害,而且存在于许多职业环境中。医护人员(HCW)可能会暴露于各种来源的电离辐射,特别是使用放射设备照射的 X 射线,他们是面临职业风险的最大工人群体,尽管加强监管和保护会导致暴露于低剂量辐射。甲状腺是对损伤最敏感的器官之一,也是红外线的一个重要目标,会导致功能性和器质性疾病。本研究旨在评估接触低剂量红外线的高危工人甲状腺激素的变化情况。研究方法对罗马 Policlinico Umberto I 教学医院的 121 名暴露于低剂量红外线的人员(78 名医护人员、17 名住院医师和 26 名放射技师学生)进行了观察,评估他们在 T1、T2 和 DeltaT 期血清中游离三碘甲状腺原氨酸、游离甲状腺素和促甲状腺激素等不同甲状腺功能参数的水平。采用线性和多元 Logistic 回归分析法对年龄、性别、甲状腺疾病史、体重指数和吸烟等可能的影响因素进行了分析。结果通过分析两次不同测量(T1和T2)的促甲状腺激素、fT3和fT4血清水平,并考虑两者之间的Delta值,调整不同的混杂因素,数据显示促甲状腺激素水平与职业暴露无关,高危工人和居民的fT3激素值下降,而高危工人的fT4激素值上升。讨论。我们的分析结果显示,医院职业对甲状腺激素的变化有影响,fT4 升高,fT3 降低,而 TSH 没有变化。这些结果与之前的研究证据相矛盾,在之前的研究中,游离甲状腺激素和促甲状腺激素都有所下降,同时促甲状腺激素也有所上升。结论暴露于低剂量红外线会影响游离甲状腺激素的水平,而促甲状腺激素没有变化,这可能会导致功能性或器质性疾病。因此,建议通过定期检查所有甲状腺激素来持续监测,以全面了解每名高危工人的情况。不过,有必要进行进一步研究,以确认激素趋势并评估任何相关的甲状腺疾病。
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Thyroid parameters variations in healthcare workers and students exposed to low-dose ionizing radiations.

Summary: Background. Ionizing Radiations (IR) are an important occupational risk factor for the potential damage that can cause to workers' health and for their presence in numerous professional settings. Health care workers (HCW) can be exposed to IR from various sources, in particular from x-rays using radiological equipment, and represent the largest group of workers occupationally at risk, despite increased regulation and protection which caused exposure to low dose radiations. The thyroid gland is one of the most sensitive organs to damage and an important target of IR, leading to functional and organic diseases. The aim of this study is to assess the variations in thyroid hormones, in a population of HCW exposed to low-dose IR. Methods. 121 individuals of the Teaching Hospital Policlinico Umberto I in Rome exposed to low-dose of IR (78 HCW, 17 Residents and 26 Radiology Technicians Students) were observed assessing serum levels of different thyroid function parameters as free triiodothyronine, free thyroxine and thyroid stimulating hormone at T1, T2 and DeltaT. Age, gender, history of thyroid diseases, BMI and smoke were analyzed as possible influencing factors using linear and multiple logistic regression analysis. Results. Analyzing TSH, fT3 and fT4 serum levels, in two different measurement (T1 and T2) and considering Delta between them, adjusting for different confounding factors, data showed no variation of TSH levels related to occupational exposure, a decrease of fT3 hormone values in HCW and residents, and an increase of fT4 in HCW. Discussion. The analysis of our results revealed that hospital occupation has an impact on thyroid hormones variations, with an increase of fT4 and a decrease of fT3 and no variations of TSH. These results are in conflict with previous studies evidences, in which both free hormones decreased with a concomitant increase of TSH. Conclusion. Exposure to low dose IR influences levels of free thyroid hormones, with no variation in TSH, which could result in a functional or organic disease. For this reason it is recommended continuous surveillance through a periodic check of all the thyroid hormones for an overall view of each HCW. However, further studies are necessary to confirm hormones trend and assess any related thyroid diseases.

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来源期刊
Giornale italiano di medicina del lavoro ed ergonomia
Giornale italiano di medicina del lavoro ed ergonomia PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
0.80
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0.00%
发文量
10
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