Using Ionizing Radiation and Effects on Medical Personnel and Patients in Healthcare Institutions
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
KOPSAVILKUMS
Jonizējošā starojuma izmantošana un ietekme uz medicīnas personālu un pacientiem veselības aprūpes iestādēs
Ievads. Veselības aprūpes iestādēs radiāciju izmanto diagnostiskos un terapeitiskos nolūkos, piem. datortomogrāfija (DT), rentgena, staru terapija un kodolmedicīna. Daudzas no šīm attēlveidošanas metodēm pakļauj pacientus jonizējošam starojumam, kas ir potenciāli kaitīgs gan pacientiem, gan strādājošajam veselības aprūpes personālam. Tas kopā ar vispārēju datu trūkumu rada bažas par šo procedūru ietekmi uz veselību.
Mērķis. Pētījuma mērķis ir novērtēt starojuma devas, ko saņem pacienti un medicīnas personāls, kā arī noteikt dažādo starojuma iedarbību uz medicīnas personālu un pacientiem radioloģisko izmeklējumu laikā.
Materiāls un metodes. Literatūras apskats sastāv tikai no aprakstošo, korelējošo un eksperimentālo kvantitatīvo tipu pētījumiem. Tika analizētas un pārskatītas zinātniskās publikācijas, kas saistītas ar jonizējošā starojuma bioloģisko iedarbību.
Rezultāti. Vairāki pētījumi liecina, ka atkārtota zemas devas starojuma iedarbība rada kumulatīvu devu, kas var pārsniegt līmeni, kad epidemioloģiskie pētījumi liecina par paaugstinātu kumulatīvās devas risku, t.i., > 50 mSv. Pētījumi atklāja saistību starp vēža izplatību un jonizējošo starojumu. Tika secināts, ka O2•− līmenis - ar radiāciju pakļautā veselības aprūpes personāla asinīs bija ievērojami augstāks nekā kontroles grupā (p> 0,05). Trīs citokīni parādīja palielinātu klātbūtni apstarotajos darbiniekos, t.i., Interleikīns-1 (IL-1), IL6 un makrofāgu iekaisuma proteīns (MIP-1α).
Secinājumi.
1. Ārstiem jāizvērtē iespējamie ieguvumi un potenciālais kaitējums abpusēji, izlemjot, vai izmantot procedūru, kas saistīta ar jonizējošo starojumu.
2. Apstiprinājās hipotēze, ka pastāv ievērojama korelācija starp jonizējošā starojuma iedarbību lielās devās veselības aprūpes iestādēs un oksidatīvā stresa, imūnsupresijas un stohastiskās ietekmes izplatību.
3. Ierīču vai sistēmu ieviešana, kas izseko pacienta uzkrāto jonizējošā starojuma kopējo jatrogēno iedarbību, visticamāk, atrisinās šo problēmu.
4. Nepieciešami turpmāki pētījumi radiobioloģijas jomā, īpaši attiecībā uz ilgtermiņa efektiem, kas saistīti ar jonizējošā starojuma iedarbību.
SUMMARY Using ionizing radiation and effects on medical personnel and patients in healthcare institutions Introduction. In healthcare institutions radiation is used for diagnostic and therapeutic purposes e.g. computed tomography (CT), X-ray, radiotherapy and nuclear medicine. Many of these imaging techniques expose patients to ionizing radiation that is potentially harmful to both patients and the operating healthcare personnel. This together with a general lack of data on the health effects associated with these procedures causes concern. Aim. The aim of the study is to assess the radiation doses received by patients and medical personnel as well as determine the various effects radiation exposure have on medical staff and patients during radiological examinations. Material and methods. The literature review consists of solely quantitative studies of the types; descriptive, correlational and experimental. Scientific publications related to the biological effects of ionizing radiations were analyzed and reviewed. Results. Several studies suggest that repeated exposure to the low dose radiation results in a cumulative dose that may exceed the levels for when epidemiological studies indicate an increased risk i.e. >50 mSv of cumulative dose. Studies have revealed the association between the prevalence of cancers and ionizing radiation. It was concluded that the level of O2•− in the blood of radiation exposed healthcare personnel was significantly higher than in the control group (p > 0.05). Three cytokines showed an increased presence in irradiated workers; Interleukin-1 (IL-1), IL6 and macrophage inflammatory protein (MIP-1α). Conclusions. 1. The physicians must weigh the potential benefits and potential harms against each other when deciding on whether to use procedures involving ionizing radiation or not. 2. The hypothesis that there is a significant correlation between high dose exposure to ionizing radiation in healthcare settings and the prevalence of oxidative stress, immunosuppression and stochastic effects was confirmed. 3. The implementation of devices or systems tracking the overall iatrogenic exposures of ionizing radiation a patient has accumulated would likely solve this problem. 4. Further research in the field of radiobiology, specifically regarding the long-term effects associated with exposure to ionizing radiation is needed.
SUMMARY Using ionizing radiation and effects on medical personnel and patients in healthcare institutions Introduction. In healthcare institutions radiation is used for diagnostic and therapeutic purposes e.g. computed tomography (CT), X-ray, radiotherapy and nuclear medicine. Many of these imaging techniques expose patients to ionizing radiation that is potentially harmful to both patients and the operating healthcare personnel. This together with a general lack of data on the health effects associated with these procedures causes concern. Aim. The aim of the study is to assess the radiation doses received by patients and medical personnel as well as determine the various effects radiation exposure have on medical staff and patients during radiological examinations. Material and methods. The literature review consists of solely quantitative studies of the types; descriptive, correlational and experimental. Scientific publications related to the biological effects of ionizing radiations were analyzed and reviewed. Results. Several studies suggest that repeated exposure to the low dose radiation results in a cumulative dose that may exceed the levels for when epidemiological studies indicate an increased risk i.e. >50 mSv of cumulative dose. Studies have revealed the association between the prevalence of cancers and ionizing radiation. It was concluded that the level of O2•− in the blood of radiation exposed healthcare personnel was significantly higher than in the control group (p > 0.05). Three cytokines showed an increased presence in irradiated workers; Interleukin-1 (IL-1), IL6 and macrophage inflammatory protein (MIP-1α). Conclusions. 1. The physicians must weigh the potential benefits and potential harms against each other when deciding on whether to use procedures involving ionizing radiation or not. 2. The hypothesis that there is a significant correlation between high dose exposure to ionizing radiation in healthcare settings and the prevalence of oxidative stress, immunosuppression and stochastic effects was confirmed. 3. The implementation of devices or systems tracking the overall iatrogenic exposures of ionizing radiation a patient has accumulated would likely solve this problem. 4. Further research in the field of radiobiology, specifically regarding the long-term effects associated with exposure to ionizing radiation is needed.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
“Radiācija”, “jonizējošais starojums”, “iedarbība”, “radiobioloģija”, “ICRP”, “oksidatīvais stress”, “stohastiskie efekti”, “deterministiskie efekti”, “vēzis”, “radiation”, “ionizing-radiation”, “exposure”, “radiobiology”, “ICRP”, “oxidative stress”, “stochastic effects”, “deterministic effects”, “cancer”