The Comparison of Health Status Between Male and Female Medical Radiation Workers in China

A systematic review on the occupational health impacts of ionising radiation exposure among healthcare professionals

Exposure to low-doses of ionising radiation can induce biological effects in healthcare professionals, such as DNA damage, genotoxic effects, lens opacities, and risk of cancer. This systematic review aims to assess the current status and identify the health impacts of occupational exposure to ionising radiation. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Articles were included only if they specifically addressed the adverse biological effects of ionising radiation on healthcare professionals, particularly in medical applications. Studies published between January 2019 and December 2023 were considered, with sources obtained from the Scopus, PubMed, and Web of Science databases. A total of 345 articles were identified through an extensive literature search, and after the complete text screening, 32 articles were deemed suitable for inclusion in the review. Eleven studies reported significantly higher micronuclei (MN) frequencies in workers exposed to ionising radiation compared to unexposed. The MN studies reviewed found a significant correlation between dose or exposure time and MN frequencies. All studies revealed significantly higher chromosomal aberrations (CA) values when exposed to ionising radiation. The occurrence of lens opacities among interventional physicians varied significantly, with rates ranging from 16% to 47%. This review emphasizes the high occurrence of cataracts, increased cancer risk, and the relevant frequency of MN and CA in workers chronically exposed to low doses.

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Medical staff represent the largest group of workers occupationally exposed to ionizing radiation (IR). Chronic exposure to low-dose IR may result in DNA damage and genotoxicity associated with increased risk of cancer. This review aims to identify the genotoxicity biomarkers that are the most elevated in IR-exposed vs. unexposed health workers. A systematic review of the literature was performed to retrieve relevant studies with various biomarkers of genotoxicity. Subsequent meta-analyses produced a pooled effect size for several endpoints. The search procedure yielded 65 studies. Chromosome aberrations (CA) and micronuclei (MN) frequencies were significantly different between IR-exposed and unexposed workers (θ_pooled = 3.19, 95% CI 1.46–4.93; and θ_pooled = 1.41, 95% CI 0.97–1.86, for total aberrant cells and MN frequencies, respectively), which was not the case for ring chromosomes and nucleoplasmic bridges. Although less frequently used, stable translocations, sister chromatid exchanges (SCE) and comet assay endpoints were also statistically different between IR-exposed and unexposed workers. This review confirms the relevance of CA and MN as genotoxicity biomarkers that are consistently elevated in IR-exposed vs. unexposed workers. Other endpoints are strong candidates but require further studies to validate their usefulness. The integration of the identified biomarkers in future prospective epidemiological studies is encouraged.