论文部分内容阅读
目的探讨天然放射性高本底地区居民肺结核死亡危险。方法建立一个包括89694例暴露和35385例非暴露的观察队列,采用队列研究方法,分阶段回顾性随访收集居民的死亡信息。将性别、到达年龄、随访年份和剂量率组(高、中、低和对照组)等作为分类变量计算人年列表,调整相应变量,计算高本底相对于对照地区各类传染病和寄生虫病,特别是肺结核的死亡相对危险(RR)。结果高本底地区40岁以上4个年龄组(40~、50~、60~和≥70)居民的肺结核死亡危险均低于对照地区,RR值(95%CI)分别为0·75(0·42~1·34)、0·72(0·49~1·07)、0·71(0·53~0·95)和0·45(0·34~0·59),其中60~和≥70年龄组两地区间的差异有统计学意义。各随访阶段均可观察到高本底地区居民肺结核死亡危险低于对照地区;两地区的肺结核死亡相对危险与累积剂量呈负向相关(P<0·001)。肺结核死亡与受照剂量的超额相对危险ERR/Sv(95%CI)=-1·09(-1·34~-0·85)。在高本底的阳东和阳西两地区,不同诊断单位、不同年龄组及不同随访阶段的肺结核死亡危险在两地区一致。结论高本底地区受低剂量电离辐射照射人群的肺结核死亡危险显著低于对照地区,且观察到了显著的剂量反应关系,这可能与高本底地区居民长期受低水平电离辐射全身照射导致的免疫功能增强有关。
Objective To explore the risk of tuberculosis death among residents with high radioactive background. Methods A total of 89,694 cases of exposure and 35,385 cases of non-exposed observation cohort were established. The death information of residents was collected by a retrospective follow-up in a cohort study. The gender, age of arrival, follow-up years and dose rate group (high, medium, low and control group) as the classification variable to calculate the year list, adjust the corresponding variables, calculate the high background compared with the control area of various infectious diseases and parasites The relative risk of death from disease, especially tuberculosis (RR). Results The risk of death from tuberculosis in residents over 40 years, 40 ~ 50, 60, and 70 years old in the high background area was lower than that in the control area. The RR values (95% CI) were 0.75 · 42 ~ 1 · 34) · 0 · 72 (0 · 49 ~ 1 · 07) · 0 · 71 (0 · 53 ~ 0 · 95) · 0 · 45 (0 · 34 ~ 0 · 59) And ≥ 70 age groups between the two regions the difference was statistically significant. The risk of death from tuberculosis in residents with high background was lower than that in the control area at each follow-up stage. The relative risk of death from tuberculosis in both areas was negatively correlated with the cumulative dose (P <0.001). The relative risk of TB death and exposure to the dose of ERR / Sv (95% CI) = -1.09 (-1.34-0.85). In the high-positive Yangdong and Yangxi areas, the risk of tuberculosis death in different diagnostic units, different age groups and different follow-up stages was consistent in both regions. CONCLUSIONS: The risk of death from tuberculosis is significantly lower in high background areas exposed to low-dose ionizing radiation and a significant dose-response relationship was observed, which may be related to the long-term population-based immunization with low level ionizing radiation Enhancements related.