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Peters CE, Quinn EK, Rodriguez-Villamizar LA, MacDonald H, Villeneuve PJ. Exposure to low-dose radiation in occupational settings and ischaemic heart disease: a systematic review and meta-analysis. Occup Environ Med 2023; 80:706-714. [PMID: 37857488 DOI: 10.1136/oemed-2023-108865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/30/2023] [Indexed: 10/21/2023]
Abstract
Ionising radiation is a human carcinogen, but the evidence is less clear that exposure to low-dose ionising radiation (LDIR) increases the risk of adverse cardiovascular outcomes. We synthesised the literature of chronic occupational exposure to LDIR and cardiovascular disease, particularly for ischaemic heart disease (IHD).The literature search was conducted using three databases including studies published between 1990 and 2022. A quality assessment of the studies was completed using the Office of Health and Assessment and Translation Risk of Bias Rating Tool. We conducted meta-analyses for IHD mortality using random effects models using measures of excess relative risk per sievert (ERR/Sv) obtained from internal cohort comparisons, as well as with standardised mortality ratios (SMRs) from external cohort comparisons.We identified 2189 articles, and of these, 26 provided data on IHD and were retained. Most studies were classified as having a 'moderate' level of risk of bias. Fourteen and 10 studies reporting external radiation doses were included in meta-analyses using SMR and ERR/Sv, respectively. The meta-summary SMR was 0.81 (95% CI 0.74 to 0.89) with evidence of reduced risk but high heterogeneity across studies. For internal cohort measures, the summary ERR/Sv for a lagged exposure of 10 years was 0.10 (95% CI 0.01 to 0.20) with low heterogeneity. The subgroup analysis by lagged exposure time showed the strongest association were for the 15 and 20 years lag.Our findings suggest that occupational exposure to LDIR increases the risk IHD mortality and highlight the relevance of internal cohort comparisons.
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Affiliation(s)
- Cheryl E Peters
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Population and Public Health, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Prevention, Screening and Hereditary Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Emma Kathleen Quinn
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Andrea Rodriguez-Villamizar
- Department of Public Health, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
- Deparment of Neurosciences, Carleton University, Ottawa, Ontario, Canada
| | | | - Paul J Villeneuve
- Deparment of Neurosciences, Carleton University, Ottawa, Ontario, Canada
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Li YM, Hu ZH, Wei J, Cao CJ, Chu YM, Yang DY, Xie QY. [A study on the correlation between occupational radiation exposure and risk of chronic metoblis disease]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:653-656. [PMID: 34624944 DOI: 10.3760/cma.j.cn121094-20200507-00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the correlation between occupational radiation exposure and chronic metabolic diseases. Methods: The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure. Results: Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group. Conclusion: Long-term exposure to IR increases the risk of chronic metabolic diseases.
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Affiliation(s)
- Y M Li
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Z H Hu
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - J Wei
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - C J Cao
- HangZhou Hospital for the Prevention and Treatment of Occupational Disease, Hangzhou 310014, China
| | - Y M Chu
- ZheJiang Elderly Care Hospital, Hangzhou 310000, China
| | - D Y Yang
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Q Y Xie
- HangZhou Hospital for the Prevention and Treatment of Occupational Disease, Hangzhou 310014, China
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Cristante AF, Barbieri F, da Silva AAR, Dellamano JC. RADIATION EXPOSURE DURING SPINE SURGERY USING C-ARM FLUOROSCOPY. Acta Ortop Bras 2019; 27:46-49. [PMID: 30774530 PMCID: PMC6362693 DOI: 10.1590/1413-785220192701172722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the radiation dose received by staff in spine surgeries, including those who are not considered occupationally exposed workers. METHODS All spinal surgeries performed in the same department during a period of 12 months were evaluated with regard to the exposure of surgeons, scrub nurses, and auxiliary personnel working in the operating room to radiation from C-arm fluoroscopy. Radiation was measured by 15 film badge dosimeters placed on the professionals' lapels, gloves, and room standardized sites. The films were analyzed in the dosimetry laboratory by collections per period. RESULTS During the 12 months, 81 spinal surgeries were performed by the same team, with surgical times ranging from 1 to 6 hours. The total radiation dose ranged from 0.16 mSv to 2.29 mSv depending on the dosimetry site. The most exposed site was the wrist of the main surgeon. CONCLUSION The results showed that in the spinal surgeries in our setting, the radiation doses are low and within legal limits. Nevertheless, constant training of professionals is essential for radiation protection of medical staff and patients. Level of evidence I/b, exploratory cohort study.
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Affiliation(s)
- Alexandre Fogaça Cristante
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Spine Surgery Division, Laboratory of Medical Investigation, São Paulo, SP, Brazil
| | - Fábio Barbieri
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (IOT-HCFMUSP), São Paulo, SP, Brazil
| | - Almy Anacleto Rodrigues da Silva
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (IOT-HCFMUSP), São Paulo, SP, Brazil
- Instituto Paulista de Dosimetria das Radiações, São Paulo, SP, Brazil
| | - José Claudio Dellamano
- Centro Universitário SantAnna, São Paulo, SP, Brazil
- Instituto de Pesquisas Energéticas e Nucleares (IPEN), São Paulo, SP, Brazil
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Abstract
Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place.
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Affiliation(s)
- Michael Yong Park
- Department of Radiology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Seung Eun Jung
- Department of Radiology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
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Gotfryd AO, Franzin FJ, Poletto PR, Neto NJC, Júnior RCN, Júnior LCLF. FRACTURE-DISLOCATION OF THE THORACIC SPINE DURING SECOND TRIMESTER OF PREGNANCY: CASE REPORT AND LITERATURE REVIEW. Rev Bras Ortop 2012; 47:521-5. [PMID: 27047862 PMCID: PMC4799457 DOI: 10.1016/s2255-4971(15)30140-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 08/04/2011] [Indexed: 11/30/2022] Open
Abstract
Spinal fractures associated with spinal cord injury rarely affect pregnant patients. The authors present the case of a 20-year-old woman in her 20th week of pregnancy, who suffered fracture-dislocation of the thoracic spine (T4-T5) and underwent decompression, reduction and posterior fusion with pedicle screws. Despite the complete spinal cord injury presented, the pregnancy progressed uneventfully and resulted in birth via normal delivery of a healthy newborn at term. Some particular features of this case, like the care needed in using ionizing radiation, the surgical approach and delivery, use of steroids and pregnancy complications in such patients are discussed here. Only a multidisciplinary team composed by physicians from different specialties (spinal surgeons, obstetricians and physiatrists), nurses and physiotherapists is capable of assisting pregnant patients with spinal cord injuries satisfactorily.
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Affiliation(s)
- Alberto Ofenhejm Gotfryd
- PhD. Chief Physician of the Spinal Disorders Group, Santa Casa da Misericórdia de Santos, Santos, SP, Brazil
| | - Fernando José Franzin
- Attending Physician in the Spinal Disorders Group, Santa Casa da Misericórdia de Santos, Santos, SP, Brazil
| | - Patricia Rios Poletto
- PhD. Adjunct Professor of the Physiotherapy Course, Federal University of São Paulo, Baixada Santista Campus, Santos, SP, Brazil
| | - Nicola Jorge Carneiro Neto
- Attending Physician in the Spinal Disorders Group, Santa Casa da Misericórdia de Santos, Santos, SP, Brazil
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Kim EK. Effect of the amount of battery charge on tube voltage in different hand-held dental x-ray systems. Imaging Sci Dent 2012; 42:1-4. [PMID: 22474641 PMCID: PMC3314831 DOI: 10.5624/isd.2012.42.1.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 10/26/2011] [Accepted: 11/20/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose Hand-held dental x-ray system is a self contained x-ray machine designed to perform intraoral radiography with one or two hands. The issue about its usage as general dental radiography is still in dispute. The aim of the present study was to assess the relationship between the amount of battery charge and the tube voltage in different hand-held dental x-ray systems. Materials and Methods Seven hand-held dental x-ray units were used for the study. Tube voltage was measured with Unfors ThinX RAD (Unfors Instruments AB, Billdal, Sweden) for 3 consecutive exposures at the different amount of battery charge of each unit. The average and the deviation percentage of measured kV from indicated kV of each unit were calculated. Results Tube voltage of only 1 unit was 70 kV (indicated by manufacturer) and those of the others were 60 kV. Tube voltage deviation percentage from the indicated kV at the fully charged battery was from 2.5% to -5.5% and from -0.8% to -10.0% at the lowest charged battery. Conclusion Tube voltages of all units decreased as the residual amount of the battery charge decreased. It is suggested that the performance test for hand-held x-ray system should be performed for the minimum residual charged battery as well as the full charged one. Persistent battery charging is suggested to maintain the proper tube voltage of the hand-held portable x-ray system.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan, Korea
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