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Article(id=1149738725824966688, tenantId=1146029695717560320, journalId=1146031787341344770, issueId=1149738718707237637, articleNumber=1003-3033(2024)08-0231-07, orderNo=null, doi=10.16265/j.cnki.issn1003-3033.2024.08.1612, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1708876800000, receivedDateStr=2024-02-26, revisedDate=1716652800000, revisedDateStr=2024-05-26, acceptedDate=null, acceptedDateStr=null, onlineDate=1752048673348, onlineDateStr=2025-07-09, pubDate=1724774400000, pubDateStr=2024-08-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1752048673348, onlineIssueDateStr=2025-07-09, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1752048673348, creator=13701087609, updateTime=1752048673348, updator=13701087609, issue=Issue{id=1149738718707237637, tenantId=1146029695717560320, journalId=1146031787341344770, year='2024', volume='34', issue='8', pageStart='1', pageEnd='252', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1752048671651, creator=13701087609, updateTime=1756376992009, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1167893010143519453, tenantId=1146029695717560320, journalId=1146031787341344770, issueId=1149738718707237637, language=EN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1167893010143519454, tenantId=1146029695717560320, journalId=1146031787341344770, issueId=1149738718707237637, language=CN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=231, endPage=237, ext={EN=ArticleExt(id=1149738726064042022, articleId=1149738725824966688, tenantId=1146029695717560320, journalId=1146031787341344770, language=EN, title=Effect of 131I nuclide therapy operation mode correction on radiation safety risk, columnId=1149735805633081985, journalTitle=China Safety Science Journal, columnName=Occupational health, runingTitle=null, highlight=null, articleAbstract=

To protect the occupational health and safety of 131I nuclear therapy workers and increase the utilization rate of 131I nuclear therapy，131I nuclear therapy workplaces in 10 hospitals in Shenzhen were selected in this study. The iodine box filter membrane sampling method，combined with a low background high-purity germanium γ energy spectrometer and passive efficiency calibration software，was used to measure the 131I activity concentration in critical areas of nuclear medicine workplaces. The accumulated effective dose of occupational personnel was estimated，and then the radiation safety risk of occupational personnel was evaluated. Furthermore，the effect of the correction factor change of 131I nuclide treatment operation on the radiation safety risk of occupational personnel was analyzed. The results showed that when the correction factor of 131I (liquid) nuclide treatment operation mode was set to 10，the radiation safety risk was far below the standard limit for manufacturer delivery and automatic packaging in nuclear medicine workplaces. It was recommended that the correction factor of the operation model of 131I (liquid) radionuclide therapy be distinguished by the packaging system，with manual packaging set to 1 and manufacturer delivery and automatic packaging set to 10.

, correspAuthors=Yong LIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Jiangping FENG, Jinfan ZHANG, Feng CHEN, Zehua LIN, Jianfeng GUO, Yong LIU), CN=ArticleExt(id=1149738726806433836, articleId=1149738725824966688, tenantId=1146029695717560320, journalId=1146031787341344770, language=CN, title=131I核素治疗操作方式修正因子对辐射安全风险的影响, columnId=1149735805817631364, journalTitle=中国安全科学学报, columnName=职业卫生, runingTitle=null, highlight=null, articleAbstract=

为更好地保障碘-131(131I)核素治疗工作人员的职业健康与安全，提高131I核素治疗的使用率，选择深圳市10家医院的131I核素治疗工作场所为研究对象开展研究。采用碘盒滤膜采样法，通过低本底高纯锗γ能谱仪和无源效率刻度软件，测量核医学工作场所关键区域中131I的活度浓度。估算职业人员待积有效剂量，评估职业人员辐射安全风险，进而探讨131I核素治疗操作方式修正因子变更对职业人员辐射安全风险的影响。结果表明：采用厂家配送和自动分装方式的核医学工作场所中，131I(液态)核素治疗操作方式修正因子设定为10时，带来的辐射安全风险仍远低于标准限值；建议将131I(液态)核素治疗操作方式修正因子按分装方式进行区分，手动分装设定为1，厂家配送和自动分装方式设定为10。

, correspAuthors=刘永, authorNote=null, correspAuthorsNote=
** 刘永 (1971—)，男，辽宁建昌人，博士，教授，主要从事核与辐射安全管理研究。E-mail：。
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冯江平 (1986—)，男，广东丰顺人，硕士，高级工程师，主要从事放射性安全监测及管理工作。E-mail：。

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冯江平 (1986—)，男，广东丰顺人，硕士，高级工程师，主要从事放射性安全监测及管理工作。E-mail：。

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冯江平 (1986—)，男，广东丰顺人，硕士，高级工程师，主要从事放射性安全监测及管理工作。E-mail：。

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Radiology, 2021, 300(3):605-612., articleTitle=Trends in occupational radiation doses for U.S. radiologic technologists performing general radiologic and nuclear medicine procedures,1980-2015, refAbstract=null), Reference(id=1167877389766893831, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2021, volume=41, issue=2, pageStart=85, pageEnd=91, url=null, language=null, rfNumber=[19], rfOrder=31, authorNames=范胜男, 王拓, 李梦雪, journalName=中华放射医学与防护杂志, refType=null, unstructuredReference=范胜男, 王拓, 李梦雪, 等. 2017年我国放射工作人员职业性外照射个人剂量水平与分析[J]. 中华放射医学与防护杂志, 2021, 41(2):85-91., articleTitle=2017年我国放射工作人员职业性外照射个人剂量水平与分析, refAbstract=null), Reference(id=1167877389829808392, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2021, volume=41, issue=2, pageStart=85, pageEnd=91, url=null, language=null, rfNumber=[19], rfOrder=32, authorNames=FAN Shengnan, WANG Tuo, LI Mengxue, journalName=Chinese Journal of Radiological Medicine and Protection, refType=null, unstructuredReference=FAN Shengnan, WANG Tuo, LI Mengxue, et al. Analysis of individual doses to radiation workers from occupational external exposure in China in 2017[J]. Chinese Journal of Radiological Medicine and Protection, 2021, 41(2):85-91., articleTitle=Analysis of individual doses to radiation workers from occupational external exposure in China in 2017, refAbstract=null), Reference(id=1167877389888528649, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2021, volume=47, issue=4, pageStart=341, pageEnd=343, url=null, language=null, rfNumber=[20], rfOrder=33, authorNames=王芳, 杨海燕, 王洁, journalName=工业卫生与职业病, refType=null, unstructuredReference=王芳, 杨海燕, 王洁, 等. 甘肃省核医学工作人员职业性外照射个人监测结果分析[J]. 工业卫生与职业病, 2021, 47(4):341-343., articleTitle=甘肃省核医学工作人员职业性外照射个人监测结果分析, refAbstract=null), Reference(id=1167877389951443210, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2021, volume=47, issue=4, pageStart=341, pageEnd=343, url=null, language=null, rfNumber=[20], rfOrder=34, authorNames=WANG Fang, YANG Haiyan, WANG Jie, journalName=Industrial Health and Occupational Diseases, refType=null, unstructuredReference=WANG Fang, YANG Haiyan, WANG Jie, et al. Analysis on personal monitoring results of occupational external irradiation of nuclear medicine workers in gansu province[J]. Industrial Health and Occupational Diseases, 2021, 47(4):341-343., articleTitle=Analysis on personal monitoring results of occupational external irradiation of nuclear medicine workers in gansu province, refAbstract=null), Reference(id=1167877390018552075, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2023, volume=49, issue=3, pageStart=272, pageEnd=275, url=null, language=null, rfNumber=[21], rfOrder=35, authorNames=牛丽梅, 刘刚, 张涵宇, journalName=工业卫生与职业病, refType=null, unstructuredReference=牛丽梅, 刘刚, 张涵宇, 等. 2019—2021年核医学工作人员内照射剂量监测结果分析[J]. 工业卫生与职业病, 2023, 49(3):272-275., articleTitle=2019—2021年核医学工作人员内照射剂量监测结果分析, refAbstract=null), Reference(id=1167877390077272332, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, doi=null, pmid=null, pmcid=null, year=2023, volume=49, issue=3, pageStart=272, pageEnd=275, url=null, language=null, rfNumber=[21], rfOrder=36, authorNames=NIU Limei, LIU Gang, ZHANG Hanyu, journalName=Industrial Health and Occupational Diseases, refType=null, unstructuredReference=NIU Limei, LIU Gang, ZHANG Hanyu, et al. Analysis of internal radiation dose monitoring results of nuclear medicine workers in 2019-2021[J]. Industrial Health and Occupational Diseases, 2023, 49(3):272-275., articleTitle=Analysis of internal radiation dose monitoring results of nuclear medicine workers in 2019-2021, refAbstract=null)], funds=[Fund(id=1167877386616971494, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, awardId=环办核设函[2021]239号, language=CN, fundingSource=生态环境部核与辐射安全监管项目(环办核设函[2021]239号), fundOrder=null, country=null), Fund(id=1167877386755383527, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, awardId=JCYJ2021032414081203, language=CN, fundingSource=深圳市科技创新委员会基础研究面上项目(JCYJ2021032414081203), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1167877382514942121, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, xref=1, ext=[AuthorCompanyExt(id=1167877382519136426, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382514942121, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 Shenzhen Ecological and Environmental Monitoring Center of Guangdong Province，Shenzhen Guangdong 518049，China), AuthorCompanyExt(id=1167877382527525035, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382514942121, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 广东省深圳生态环境监测中心站，广东 深圳 518049)]), AuthorCompany(id=1167877382590439596, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, xref=2, ext=[AuthorCompanyExt(id=1167877382598828205, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382590439596, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 Shenzhen Ecological Environment Bureau，Shenzhen Guangdong 518113，China), AuthorCompanyExt(id=1167877382611411118, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382590439596, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 深圳市生态环境局，广东 深圳 518113)]), AuthorCompany(id=1167877382665937071, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, xref=3, ext=[AuthorCompanyExt(id=1167877382674325680, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382665937071, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3 Institute for Advanced Study in Nuclear Energy & Safety，Shenzhen University，Shenzhen Guangdong 518060，China), AuthorCompanyExt(id=1167877382678519985, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, companyId=1167877382665937071, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3 深圳大学 深圳大学中国核能与安全高等研究院，广东 深圳 518060)])], figs=[ArticleFig(id=1167877385413206236, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=EN, label=Table 1, caption=

Summary of 131I nuclear medicine workplaces in Shenzhen

, figureFileSmall=null, figureFileBig=null, tableContent=
核医学工
作场所		 日均操作
量/Bq		 操作方式 操作
人数		 年操作
时间/h
A医院 7.40×108 厂家分装，确认
药量后给药		 1 100
B医院 2.59×1010 厂家分装，确认
药量后给药		 5 200
C医院 2.59×1010 自动分装、给药 4 200
D医院 7.40×108 厂家分装，确认
药量后给药		 2 100
E医院 7.40×108 厂家分装，确认
药量后给药		 2 100
F医院 1.85×109 厂家分装，确认
药量后给药		 6 100
G医院 7.40×108 厂家分装，确认
药量后给药		 3 100
H医院 5.55×108 厂家分装，确认
药量后给药		 2 100
I医院 7.4×108 厂家分装，确认
药量后给药		 3 100
J医院 1.85×109 厂家分装，确认
药量后给药		 3 100
), ArticleFig(id=1167877385564201181, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=CN, label=表1, caption=

深圳市使用131I核医学工作场所汇总

, figureFileSmall=null, figureFileBig=null, tableContent=
核医学工
作场所		 日均操作
量/Bq		 操作方式 操作
人数		 年操作
时间/h
A医院 7.40×108 厂家分装，确认
药量后给药		 1 100
B医院 2.59×1010 厂家分装，确认
药量后给药		 5 200
C医院 2.59×1010 自动分装、给药 4 200
D医院 7.40×108 厂家分装，确认
药量后给药		 2 100
E医院 7.40×108 厂家分装，确认
药量后给药		 2 100
F医院 1.85×109 厂家分装，确认
药量后给药		 6 100
G医院 7.40×108 厂家分装，确认
药量后给药		 3 100
H医院 5.55×108 厂家分装，确认
药量后给药		 2 100
I医院 7.4×108 厂家分装，确认
药量后给药		 3 100
J医院 1.85×109 厂家分装，确认
药量后给药		 3 100
), ArticleFig(id=1167877385748750558, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=EN, label=Table 2, caption=

Measurements of 131I in aerosols

, figureFileSmall=null, figureFileBig=null, tableContent=
工作
场所		 检测
点位		 检测结果/
(Bq·m-3)		 工作
场所		 检测
点位		 检测结果/
(Bq·m-3)
A医院 给药室 0.32 F医院 给药室 38.1
给药室 0.01 G医院 给药室 43.50
候诊
走廊		 0.01 注射室 未检出
B医院 碘质
控室		 0.87 H医院 投药注
射室		 未检出
碘病房
走廊		 9.62 投药注
射室		 0.378
C医院 自动分装
柜旁		 61.81 I医院 二楼准
备室		 未检出
D医院 分装
柜旁		 未检出 J医院 注射窗 未检出
E医院 注射室 未检出 服药窗 20.30
SPECT
机房		 未检出
), ArticleFig(id=1167877385916522719, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=CN, label=表2, caption=

气溶胶中131I检测结果

, figureFileSmall=null, figureFileBig=null, tableContent=
工作
场所		 检测
点位		 检测结果/
(Bq·m-3)		 工作
场所		 检测
点位		 检测结果/
(Bq·m-3)
A医院 给药室 0.32 F医院 给药室 38.1
给药室 0.01 G医院 给药室 43.50
候诊
走廊		 0.01 注射室 未检出
B医院 碘质
控室		 0.87 H医院 投药注
射室		 未检出
碘病房
走廊		 9.62 投药注
射室		 0.378
C医院 自动分装
柜旁		 61.81 I医院 二楼准
备室		 未检出
D医院 分装
柜旁		 未检出 J医院 注射窗 未检出
E医院 注射室 未检出 服药窗 20.30
SPECT
机房		 未检出
), ArticleFig(id=1167877386059129056, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=EN, label=Table 3, caption=

Evaluations of average accumulated effective dose of 131I internal exposure for occupational personnel

, figureFileSmall=null, figureFileBig=null, tableContent=
工作
场所		 检测
结果/
(Bq·
m-3)		 计算参数 人均待积
有效剂量/
(mSv·a-1)
年操
作时
间/h		 人呼
吸率/
(m3·
h-1)		 剂量
系数/
(Sv·
Bq-1)
A医院 0.32 100 0.83 2×10-8 5.31×10-4
B医院 0.87 200 0.83 2×10-8 4.78×10-4
C医院 61.81 200 0.83 2×10-8 5.13×10-2
F医院 38.1 100 0.83 2×10-8 1×10-2
G医院 43.5 100 0.83 2×10-8 1.4×10-2
H医院 0.378 100 0.83 2×10-8 3.14×10-4
J医院 20.3 100 0.83 2×10-8 1.12×10-2
), ArticleFig(id=1167877386184958177, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=CN, label=表3, caption=

职业人员131I内照射人均待积有效剂量估算结果

, figureFileSmall=null, figureFileBig=null, tableContent=
工作
场所		 检测
结果/
(Bq·
m-3)		 计算参数 人均待积
有效剂量/
(mSv·a-1)
年操
作时
间/h		 人呼
吸率/
(m3·
h-1)		 剂量
系数/
(Sv·
Bq-1)
A医院 0.32 100 0.83 2×10-8 5.31×10-4
B医院 0.87 200 0.83 2×10-8 4.78×10-4
C医院 61.81 200 0.83 2×10-8 5.13×10-2
F医院 38.1 100 0.83 2×10-8 1×10-2
G医院 43.5 100 0.83 2×10-8 1.4×10-2
H医院 0.378 100 0.83 2×10-8 3.14×10-4
J医院 20.3 100 0.83 2×10-8 1.12×10-2
), ArticleFig(id=1167877386260455650, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=EN, label=Table 4, caption=

131I usage in nuclear medicine workplaces in Shenzhen

, figureFileSmall=null, figureFileBig=null, tableContent=
工作场所 131I日等
效最大
操作量/Bq		 工作场所日
等效最大
操作量/Bq		 131I
占比/%
A医院 7.40×107 7.77×107 95.24
B医院 2.59×109 2.60×109 99.62
C医院 1.85×109 1.85×109 99.80
D医院 7.40×107 9.99×107 74.07
E医院 7.40×107 7.59×107 97.50
F医院 1.85×108 1.99×108 92.96
G医院 7.40×107 8.88×107 83.33
H医院 5.55×107 5.99×107 92.65
I医院 7.40×107 1.04×108 71.15
J医院 1.85×108 1.89×108 97.88
合计 5.24×109 5.35×109 97.90
), ArticleFig(id=1167877386319175907, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=CN, label=表4, caption=

深圳市核医学工作场所131I使用情况

, figureFileSmall=null, figureFileBig=null, tableContent=
工作场所 131I日等
效最大
操作量/Bq		 工作场所日
等效最大
操作量/Bq		 131I
占比/%
A医院 7.40×107 7.77×107 95.24
B医院 2.59×109 2.60×109 99.62
C医院 1.85×109 1.85×109 99.80
D医院 7.40×107 9.99×107 74.07
E医院 7.40×107 7.59×107 97.50
F医院 1.85×108 1.99×108 92.96
G医院 7.40×107 8.88×107 83.33
H医院 5.55×107 5.99×107 92.65
I医院 7.40×107 1.04×108 71.15
J医院 1.85×108 1.89×108 97.88
合计 5.24×109 5.35×109 97.90
), ArticleFig(id=1167877386390479076, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=EN, label=Table 5, caption=

131I operation mode correction factor

, figureFileSmall=null, figureFileBig=null, tableContent=
活动类型 核素及状态 操作方
式界定		 操作方式
修正因子
核素治疗 手动分装131I(液体) 简单操作 1
自动分装、厂家
配送131I(液体)		 很简单操作 10
), ArticleFig(id=1167877386445005029, tenantId=1146029695717560320, journalId=1146031787341344770, articleId=1149738725824966688, language=CN, label=表5, caption=

131I操作方式修正因子

, figureFileSmall=null, figureFileBig=null, tableContent=
活动类型 核素及状态 操作方
式界定		 操作方式
修正因子
核素治疗 手动分装131I(液体) 简单操作 1
自动分装、厂家
配送131I(液体)		 很简单操作 10
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131I核素治疗操作方式修正因子对辐射安全风险的影响
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冯江平 1 , 张金帆 1 , 陈峰 2 , 林择华 1 , 郭键锋 1 , 刘永 3, **
中国安全科学学报 | 职业卫生 2024,34(8): 231-237
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中国安全科学学报 | 职业卫生 2024, 34(8): 231-237
131I核素治疗操作方式修正因子对辐射安全风险的影响
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冯江平1 , 张金帆1, 陈峰2, 林择华1, 郭键锋1, 刘永3, **
作者信息
  • 1 广东省深圳生态环境监测中心站，广东 深圳 518049
  • 2 深圳市生态环境局，广东 深圳 518113
  • 3 深圳大学 深圳大学中国核能与安全高等研究院，广东 深圳 518060

    • 冯江平 (1986—)，男，广东丰顺人，硕士，高级工程师，主要从事放射性安全监测及管理工作。E-mail：。

通讯作者:

** 刘永 (1971—)，男，辽宁建昌人，博士，教授，主要从事核与辐射安全管理研究。E-mail：。
Effect of 131I nuclide therapy operation mode correction on radiation safety risk
Jiangping FENG1 , Jinfan ZHANG1, Feng CHEN2, Zehua LIN1, Jianfeng GUO1, Yong LIU3, **
Affiliations
  • 1 Shenzhen Ecological and Environmental Monitoring Center of Guangdong Province，Shenzhen Guangdong 518049，China
  • 2 Shenzhen Ecological Environment Bureau，Shenzhen Guangdong 518113，China
  • 3 Institute for Advanced Study in Nuclear Energy & Safety，Shenzhen University，Shenzhen Guangdong 518060，China
出版时间: 2024-08-28 doi: 10.16265/j.cnki.issn1003-3033.2024.08.1612
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摘要
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为更好地保障碘-131(131I)核素治疗工作人员的职业健康与安全，提高131I核素治疗的使用率，选择深圳市10家医院的131I核素治疗工作场所为研究对象开展研究。采用碘盒滤膜采样法，通过低本底高纯锗γ能谱仪和无源效率刻度软件，测量核医学工作场所关键区域中131I的活度浓度。估算职业人员待积有效剂量，评估职业人员辐射安全风险，进而探讨131I核素治疗操作方式修正因子变更对职业人员辐射安全风险的影响。结果表明：采用厂家配送和自动分装方式的核医学工作场所中，131I(液态)核素治疗操作方式修正因子设定为10时，带来的辐射安全风险仍远低于标准限值；建议将131I(液态)核素治疗操作方式修正因子按分装方式进行区分，手动分装设定为1，厂家配送和自动分装方式设定为10。

131I核素治疗  /  操作方式  /  修正因子  /  辐射安全风险  /  核医学工作场所  /  内照射

To protect the occupational health and safety of 131I nuclear therapy workers and increase the utilization rate of 131I nuclear therapy，131I nuclear therapy workplaces in 10 hospitals in Shenzhen were selected in this study. The iodine box filter membrane sampling method，combined with a low background high-purity germanium γ energy spectrometer and passive efficiency calibration software，was used to measure the 131I activity concentration in critical areas of nuclear medicine workplaces. The accumulated effective dose of occupational personnel was estimated，and then the radiation safety risk of occupational personnel was evaluated. Furthermore，the effect of the correction factor change of 131I nuclide treatment operation on the radiation safety risk of occupational personnel was analyzed. The results showed that when the correction factor of 131I (liquid) nuclide treatment operation mode was set to 10，the radiation safety risk was far below the standard limit for manufacturer delivery and automatic packaging in nuclear medicine workplaces. It was recommended that the correction factor of the operation model of 131I (liquid) radionuclide therapy be distinguished by the packaging system，with manual packaging set to 1 and manufacturer delivery and automatic packaging set to 10.

131I nuclear therapy  /  operating mode  /  correction factor  /  radiation safety risk  /  nuclear medicine workplace  /  internal radiation
冯江平, 张金帆, 陈峰, 林择华, 郭键锋, 刘永. 131I核素治疗操作方式修正因子对辐射安全风险的影响. 中国安全科学学报, 2024 , 34 (8) : 231 -237 . DOI: 10.16265/j.cnki.issn1003-3033.2024.08.1612
Jiangping FENG, Jinfan ZHANG, Feng CHEN, Zehua LIN, Jianfeng GUO, Yong LIU. Effect of 131I nuclide therapy operation mode correction on radiation safety risk[J]. China Safety Science Journal, 2024 , 34 (8) : 231 -237 . DOI: 10.16265/j.cnki.issn1003-3033.2024.08.1612
正文
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0 引言
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近年来，甲状腺癌(Thyroid Carcinoma，TC)的发病率呈现出上升趋势[1]，而碘-131(131I，是一种碘的放射性同位素，核素符号为I)治疗法，可通过131I发射射线破坏癌变和转移病灶，防止TC复发[2]。131I治疗法在TC患者中的应用越来越普遍，一定程度上提高了TC患者的愈后生活质量，但随之带来的放射性内照射问题亦开始受到医患双方的重视[3]。由于131I挥发性强，核医学工作人员治疗操作期间，易通过呼吸道或皮肤渗透途径摄入，从而造成内照射[4-5]。内照射无法通过一般的时间、距离和屏蔽等方法控制，是较危险的照射类型。因此，开展131I对职业人员辐射安全风险研究具有重要意义。
国内外关于131I对职业人员内照射的研究越来越重视[6⇓⇓-9]，其中，国外BRUDECKI等[6]对波兰某核医疗医院核医务人员进行了甲状腺131I活性测定及内照射剂量评估；MOLLAH等[7]利用国际原子能机构的辐射剂量标准来评估测定核医学实践中的内部辐射剂量。国内龙旋等[8]采用体外直接测量法，评估了广东省8家医院的61名核素治疗核医学工作人员的内照射水平，结果表明：虽然8家医院的工作人员内照射水平符合年有效剂量限值，但仍需重视内照射防护。王洁等[9]监测和估算了甘肃省3家甲级医院的 20 名从事核医学工作的医务人员的甲状腺中131I 内照射剂量，结果显示，所有人员年待积有效剂量均未超过必须进行内照射监测的1 mSv 限值，但也较为接近，还需密切关注。深圳市作为改革开放先行示范区，仅2021年，就有10个新增申报的核医学相关项目[10]，而131I核素治疗就是其中的重要组成部分之一。
鉴于此，笔者选择深圳市10家医院的131I核素治疗工作场所为研究对象，采用γ能谱仪无源效率刻度方法，调查核医学场所中131I的活度浓度，评估工作人员的辐射安全风险，以期为131I核素治疗的发展和安全管理提出建议。
1 131I核素治疗使用情况
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根据调研报告[10]，截至2021年6月30日，深圳市已许可使用131I核素的非密封放射性物质工作场所有10家，现场调查情况见表1。从表1可以看出：①从131I日均实际操作量来看，日均操作量不大，日工作时间一般在2~4 h。②大部分由专业核素制药厂家分装好后，直接按人份送至医院，大大减少了医护人员的操作时间。
2 辐射安全风险调查方法
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利用高纯锗(High Purity Germanium，HPGe)探测器组成的低本底HPGe γ能谱仪开展辐射安全风险调查工作，测定核素衰变发射的具有不同能量特征的γ射线。以《空气中碘-131的取样与测定》[11]和《环境空气 气溶胶中γ放射性核素的测定 滤膜压片/γ能谱法》[12]为依据，利用低本底HPGeγ能谱仪，测量131I衰变放出364.5 keV的 γ射线能量峰。为了消除碘盒中碘分布不均匀产生的测量误差，一般需测量碘盒正反面各1次后取平均值。用无源效率刻度软件进行仪器效率刻度。最终结果为通过时间修正到取样时刻时131I的活度浓度。
使用携式碘/气溶胶采样器进行采样，分析设备使用低本底HPGeγ能谱仪，检出限为0.002 Bq/m3。
1) 采样点。在职业人员操作、分装和注射的位置以及人员站立地表面向上1.5 m处的呼吸带，1个位置选择1个采样点；同时，选择候诊区或走廊等预计活度浓度高的位置，或者工作场所外预计活度浓度低的位置作为对照点。
2) 采样时段。在工作人员准备操作前，架设好采样设备，设置好采样滤膜/试剂，在操作过程中采集气溶胶，采样时间包含当天整个操作过程，操作结束后，适当延长1 h左右采样时间。
3) 采样量。为保证采集到足够多的放射性物质，同时满足γ谱仪的最低探测下限及统计学要求的数值，采样设备设置的采样流量均按最大流量进行采样，以保证抽取足够体积的空气，实际采样流量为120 L/min，采样体积为14.4~43.2 m3。气溶胶测量结果详见表2。
3 辐射安全风险影响分析
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职业人员待积有效剂量反映了职业人员在131I核素治疗操作过程当中收到的辐射影响程度，是评价辐射安全风险的重要指标。依据《职业性内照射个人监测规范》(GBZ 129—2016)[13]和《核医学放射防护要求》[14]的内照射待积有效剂量估算方法，从事非密封放射性核素操作的工作人员摄入放射性核素所致待积有效剂量采用下式进行估算：
E ( τ ) = I j e j ( τ )
式中：E(τ)为待积有效剂量，Sv;Ij为j类核素通过吸入途径摄入的摄入量，Bq;ej(τ)为j类核素通过吸入途径引起的待积有效剂量系数(单位摄入量的待积有效剂量)，Sv/Bq，取值见GBZ129—2016[13]附录E。
当空气样品个人监测的测量结果是监测周期内的累积放射性活度时，则可直接视为此时的摄入量。若监测结果是核素空气活度浓度Cj，核素j的摄入量Ij可用下式计算：
I j = C j B T
式中：Cj为监测的j类放射性核素的活度浓度，Bq/m3;B为人的呼吸率，m3/h，取0.83 m3/h;T为1年内在工作场所停留的总有效时间，h。
根据气溶胶的测量结果及式(2)，对气溶胶监测结果高于检出限，且有职业人员居留的操作、分装和注射的位置进行待积有效剂量估算。医疗应用单位职业人员人均待积有效剂量估算结果见表3。
从估算结果可以看出，职业人员待积有效剂量估算结果整体不高。
1) 6家医院均为供药厂家供药分装好的药物，质控确认药量后给药，年操作时间为100或200 h;1家医院为院内自动分装设备进行分装，年操作时间为100 h。所有调查医院131I核素治疗导致的职业人员人均待积有效剂量为4.78×10-4~5.13×10-2mSv/a，均远低于《电离辐射防护与辐射源安全标准》(GB 18871—2002))[15]的标准限值(1 mSv/a)。
2) C医院院内使用自动分装设备进行自动分装，自动分装柜旁131I气溶胶活度浓度检测结果最高(61.81 Bq/m3)。这是由于碘源液在自动分装过程中长时间处于暴露状态，导致在分装柜旁采集到的气溶胶浓度较大。按分装柜旁采集的气溶胶活度浓度保守估算出来的集体待积有效剂量为0.205 mSv/a，人均待积有效剂量为0.05 mSv/a。但是在实际的操作过程中，工作人员把药放进自动分装柜后，不在分装柜旁停留，而是在分装柜对面的值班室进行远程操作，真实的人均待积有效剂量远低于估算值。
4 131I操作方式修正因子探讨
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核医学工作场所属于非密封源工作场所，GB 18871—2002[15]按放射性核素日等效最大操作量的大小对非密封源工作场所进行分级(甲：>4×109Bq;乙：2×107~4×109Bq;丙：豁免活度值以上~2×107Bq)。放射性核素的日等效操作量等于放射性核素的实际日操作量(Bq)与该核素毒性组别修正因子的积除以与操作方式有关的修正因子所得的商。甲级管理要求最高，乙级次之，丙级最低。由此可以看出，修正因子越大，其对应的实际日操作量越低，在相同的日等效最大操作量前提下，可用的放射性核素的量也越多。对于使用131I作为核素治疗的工作场所，我国核医学的环境标准HJ 1188—2021《核医学辐射防护与安全要求》[16] 将统一使用131I(液态)核素治疗的操作方式界定为简单操作，131I(液态)核素治疗操作方式修正因子(简称修正因子)设定为1。
根据深圳市典型核医学工作场所的日等效最大操作量统计情况，可以发现131I在核医学的日等效最大操作量比重最高可达到99.80%，平均达到97.90%，见表4。其主要原因是131I相对其他使用核素的操作修正因子大1个数量级，而131I在核医学中的甲状腺治疗应用较为普遍。据不完全统计，仅2022年，深圳市内申报安装自动分装设备的核医学131I项目就超过10个。如果核医学工作场所只是简单的提高131I实际最大操作量，将随之提高日等效最大操作量，从而导致整个核医学工作场所的分级由乙级提高为甲级，管理要求将会大幅度增加，限制了核医学的发展。在保证所有核素造成的日等效最大操作量不变的前提下，如果提高131I的操作方式修正因子，能够降低131I造成的实际最大操作量，从而增加核医学其他核素的实际最大操作量，将有利于促进核医学的发展，满足民生需求。
5 修正因子对辐射安全风险的影响
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5.1 厂家配送与自动分装的辐射安全风险
由表2和表3可知：131I活度浓度范围为0.002~61.81 Bq/m3，人均待积有效剂量为3.14×10-4~5.13×10-2 mSv/a。监测结果与林宝等[17]监测结果基本一致(131I活度浓度范围为0.087 ~570 Bq/m3，人均待积有效剂量为2×10-3~10 mSv/a)。
国内外文献报道，核医学操作过程中，工作人员直接接触放射性核素，相比于普通放射工作人员，核医学工作人员受照剂量更高[18⇓⇓-21]。例如：牛丽梅等[21]调查了4家三甲医院的85名核医学科工作人员内照射情况，结果表明：内照射剂量估算结果≥5 mSv/a的人员仅有3名，且均为长期从事放射性核素分装及给药的工作人员。由此可见：核医学工作人员的受照剂量主要问题来源于分装及给药工作。林宝等[16]也指出检测结果的差异性与分装方式、操作频率和工作量均有关系，但是并未对分装方式带来的差异性进行详细的比较。
随着自动化精密机械技术的发展，核医学放射性药物的分装方式由传统的手动分装发展成了自动分装方式。相较于手动分装方式，自动分装方式不需要进行人为的操作。人员实际在该区域居留时间非常短，大大减少了人员接触放射性药物的机会，同时也减少了分装对人员带来的危害。此外，从自动分装的机械设计和人员操作方式方面考虑，只要自动分装的设计和辐射防护设计符合辐射安全防护原则，医院内采用自动分装方式对工作人员和环境的影响基本上等同于厂家分装定量配送方式。
文中首次对分装方式带来的辐射安全风险进行分析研究，结果表明厂家配送和自动分装方式对场所的环境影响低，所带来的人均待积有效剂量远低于GB 18871—2002[15]标准(5 mSv/a)要求。厂家配送方式和自动分装应与手动分装区别对待，其操作修正因子也应相应有所区别。
5.2 提高修正因子对辐射安全风险的影响
以131I日等效操作量最大的B医院(2.59×109Bq)为例，其131I日等效操作量占工作场所日等效最大操作量(2.60×109Bq)的99.62%，占乙级工作场所最大日等效操作量(4×109Bq)的64.75%。
以人均待积有效剂量最大的C医院(5.13×10-2mSv/a)为例，其131I日等效操作量占工作场所日等效最大操作量(1.85×109Bq)的99.8%;按保守估算，当增大10倍的131I日等效操作量，其人均待积有效剂量将随之增大10倍，达到5.13×10-1mSv/a;但是即使如此，仍然远低于标准要求。
换言之，如果将采用厂家配送和自动分装方式的131I(液态)操作方式修正因子增加10倍，核医学工作场所可提高10倍的131I日等效操作量，其导致的人均待积有效剂量仍远低于标准要求，满足辐射安全的要求。其次，此操作方式修正因子的增加，可以有效的放开核医学其他核素的使用空间，促进核医学的快速有效发展。
综上所述，建议将131I(液态)操作方式修正因子按厂家配送、自动分装和手动分装进行区分，将厂家配送和自动分装的131I(液态)操作方式修正因子定义为10，将手动分装的131I(液态)操作方式修正因子定义为1。131I操作方式修正因子见表5。
6 结论
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1) 采用厂家分装和自动分装方式的医院，其131I核素治疗导致的职业人员人均待积有效剂量为4.78×10-4~5.13×10-2mSv/a，均远低于GB 18871—2002[15]的标准限值(1 mSv/a)。
2) 如果将采用厂家配送和自动分装方式的131I(液态)操作方式修正因子增加10倍，核医学工作场所可提高10倍的131I日等效操作量，其导致的人均待积有效剂量仍远低于标准要求。建议将131I(液态)操作方式修正因子按厂家配送、自动分装和手动分装进行区分，将厂家配送和自动分装的131I(液态)操作方式修正因子设定为10，将手动分装的131I(液态)操作方式修正因子设定为1。
3) 文中仅监测调查对象1次，不能充分反映核医学科不同核素使用量情况下的内照射结果。使用1次监测的结果来估算全年的内照射剂量，可能存在一定的误差。因此，下一步将根据核医学科放射性核素使用情况调整监测周期，增加监测频次，以便能客观评价其年有效剂量。
4) 文中只重点讨论了131I的修正因子，未深入研究核医学其他核素的使用情况。随着核医学设备及防护装置的快速发展，放射性药物对区域的辐射水平影响将逐步减少，下一步将深入研究其他核素的操作方式修正因子。
基金
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  • 生态环境部核与辐射安全监管项目(环办核设函[2021]239号)
  • 深圳市科技创新委员会基础研究面上项目(JCYJ2021032414081203)
文献
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2024年第34卷第8期
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doi: 10.16265/j.cnki.issn1003-3033.2024.08.1612
  • 接收时间：2024-02-26
  • 首发时间：2025-07-09
  • 出版时间：2024-08-28
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  • 收稿日期：2024-02-26
  • 修回日期：2024-05-26
基金
生态环境部核与辐射安全监管项目(环办核设函[2021]239号)
深圳市科技创新委员会基础研究面上项目(JCYJ2021032414081203)
作者信息
    1 广东省深圳生态环境监测中心站，广东 深圳 518049
    2 深圳市生态环境局，广东 深圳 518113
    3 深圳大学 深圳大学中国核能与安全高等研究院，广东 深圳 518060

通讯作者:

** 刘永 (1971—)，男，辽宁建昌人，博士，教授，主要从事核与辐射安全管理研究。E-mail：。
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