Occupational ionizing radiation-induced skin injury among orthopedic surgeons: A clinical survey
Occupational ionizing radiation-induced skin injury among orthopedic surgeons: A clinical survey
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DOI：
10.1016/j.jos.2020.11.008
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发表时间：
2022-01-17
影响因子：
1.7
通讯作者：
Ishibashi, Yasuyuki
中科院分区：
文献类型：
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作者：
Asari, Toru;Rokunohe, Daiki;Ishibashi, Yasuyuki
背景：本研究旨在了解骨科医生对职业性放射暴露的态度和行为，并调查骨科医生职业性放射性皮肤损伤的患病率。同样，对放射性皮肤损伤的危险因素进行了调查。方法：对108名骨科医生进行自填式职业辐射暴露问卷调查，并拍摄手部照片。他们的专业领域分为脊柱、关节成形术、运动医学、手部、肿瘤学、类风湿性关节炎、儿科骨科和住院医师。皮肤科医生评估了外科医生的皮肤状况，并将其分为3级：0级，没有临床症状；1级，需要仔细观察；2级，需要详细检查。对放射性皮肤损伤的相关因素进行Logistic回归分析。采用向后逐步选择法进行粗略和调整后的Logistic回归分析。结果：93.5%的外科医生对职业性辐射暴露持谨慎态度，其中76.8%的医生使用了剂量计。42.5%的外科医生自我报告了手部皮肤的变化，31.4%的外科医生诊断出了放射性皮肤损伤。2级皮肤科医生自报皮肤变化的准确率为100%，1级皮肤科医生诊断的准确率为61.5%。调整回归分析显示，皮肤科医生诊断的相关因素是皮肤科医生自报皮肤变化(优势比[OR]3.1)和脊柱外科医生(OR 3.2)。ROC分析表明，职业年限和累积暴露时间分别为21年和6696min，OR值分别为4.07和5.99。结论：骨科医生，尤其是脊柱外科医生，应在其职业生涯的早期定期接受皮肤科医生的检查，以便及早发现手部放射性皮肤损伤。(C)2020年日本整形外科协会。爱思唯尔出版，版权所有。
Background: This study aimed to assess orthopedic surgeons' attitudes and behaviors toward occupational radiation exposure and investigate the prevalence of occupational radiation-induced skin injury among orthopedic surgeons. Similarly, risk factors for the presence of radiation-induced skin injury were investigated.Methods: Overall, 108 orthopedic surgeons were administered self-reported questionnaires about occupational radiation exposure, and their hands were then photographed. Their fields of expertise were classified into spine, arthroplasty, sports medicine, hand, oncology, rheumatoid arthritis, pediatric orthopedic, and resident. Dermatologists evaluated the surgeons' skin conditions and classified into 3 grades of injury: grade 0, no clinical symptoms; grade 1, careful observation required; and grade 2, detailed examination required. Logistic regression analysis was performed to investigate the factors related to the presence of radiation-induced skin injury. Crude and adjusted logistic regression analysis using the backward stepwise selection method was similarly conducted. Receiver operating characteristic curve (ROC) analysis was performed to estimate the predictive power of exposure time, occupational period, and accumulated annual exposure time for radiation-induced skin injury.Results: In total, 93.5% of the surgeons were careful about occupational radiation exposure, of which 76.8% used a dosimeter. Skin changes in the hands were self-reported by 42.5% of the surgeons, and radiation-induced skin injury was diagnosed in 31.4%. The accuracy of the self-reported skin changes was 100% for grade 2 and 61.5% for grade 1. Adjusted regression analysis showed that dermatologists' diagnosis-related factors were self-reported skin changes (odds ratio [OR] 3.1) and spine surgeons (OR 3.2). ROC analysis demonstrated that an occupational period >21 years and an accumulated exposure time >6696 min were considered risk factors, with ORs of 4.07 and 5.99, respectively.Conclusions: Orthopedic surgeons, particularly spine surgeons, should be regularly examined by dermatologists early in their careers for early detection of radiation-induced skin injury on the hands. (C) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.