Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses
Abstract
:1. Introduction
2. Methods
2.1. Online Searches
2.2. Selection Criteria
2.3. Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Cytogenetic Biomarkers
3.2. DNA Integrity Biomarkers
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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PECO elements | PECO Question Formulation: What genotoxicity biomarkers can be used in future similar reviews or future prospective epidemiological studies to examine their association with long-term health outcomes following IR-exposure? |
Population | All studies involving medical workers, regardless of the profession and service |
Exposure | Studies dealing with ionizing radiation from medical sources and containing dose estimates or surrogates |
Comparator |
|
Outcome | Frequencies of micronuclei or chromosome aberrations or sister chromatid exchanges, telomere length and DNA damage parameters |
Study | Country Sample Size Design | Healthcare Services, Department, Units, Occupations of Hospital Workers Exposed to IR | Exposure Assessment (Mean of Exposure) a and/or Type of Exposure | Biomarker(s) | Major Results | NOS Score |
---|---|---|---|---|---|---|
Andreassi et al. (2009) [27] | Italy N = 77 40 exposed/ 37 unexposed | Cardiac catheterization laboratories (interventional cardiologists) | Badge doses (1.6 ± 2.4 mSv for the last 6 months) DOE to IR (12.0 ± 9.9 years) | MN | 19.7 ± 7.8 (E); 13.5 ± 6.3 (NE) R: 0.265 β = 0.34 (p = 0.004) | 6 |
Andreassi et al. (2015) [28] | Italy N = 445 223 exposed/ 222 unexposed | Catheterization laboratories | Lifetime cumulative professional exposure reconstruction (21.1 ± 26.3 mSv) DOE to IR (12.2 ± 8.3 years) ORRS (18.5 ± 20) | Leukocyte telomere length | R: −0.319 β = −0.14 (p = 0.03) | 6 |
Andreassi et al. (2020) [29] | Italy N = 130 83 exposed/ 47 unexposed | Catheterization laboratories (Cath lab workers) | DOE to IR (median = 6 years (IQR 1–25)) ORRS (median = 11 (IQR = 1–63)) | Copy number status (microdeletion and microduplication) in AZFc region for two markers | ORadjusted (SY1197) = 2.66 (95% CI: 1.09–6.31), p = 0.02 | 6 |
Angelini et al. (2005) [30] | Germany N = 42 21 exposed/ 21 unexposed | Units of Radiology Radiotherapy Cardiology (physicians and technicians) | Badge doses (40.6 ± 37.7 mSv) | MN | MN: 8.6 ± 2.8 (E); 6.7 ± 2.7 (NE) β = 0.004 (p = 0.941) | 6 |
Bhatti et al. (2007) [31] | USA N = 152 Cohort | Radiologic technologists who began working before 1950 (USRT study) | Estimated cumulative occupational red bone marrow radiation dose score (1.9 ± 1.4 cGy) | FISH for translocations | ERR = 0.09/100 CE per mGy (95% CI −0.01–0.20, p = 0.07) | 7 |
Bouraoui et al. (2013) [32] | Tunisia N = 110 67 exposed/ 43 unexposed | Nuclear medicine Radiology Orthopedic Radiotherapy Physiology Cardiology departments | DOE to IR (18.4 ± 9.3 years) X-ray, γ-ray,125I, 131I, 57CO, etc. | MN | 13.6 ± 4.9 (E); 6.5 ± 4.2 (NE) β = 0.7 (p = 0.04) | 6 |
Caradonna (2015) [33] | Italy N = 110 56 exposed/ 54 unexposed | (clinicians, technicians, attendants) | - | NPB CA (Chromatid breaks, chromosomal breaks, dicentrics, radial configurations) | CA: 2.87 ± 0.17 (E); 1.15 ± 0.05 (NE) NPB: 5.18 ± 0.23 (E); 1.42 ± 0.15 (NE) | 3 |
Cigarran et al. (2001) [34] | Spain N = 38 20 exposed 18 unexposed | Badge doses (38.1 ± 31.7 mSv) | CA (translocations, dicentrics) | Translocations: 1.04 ± 0.11 (E); 0.90 ± 0.12 (NE) Dicentrics: 0.09 ± 0.03 (E); 0.15 ± 0.04 (NE) | 4 | |
Dias et al. (2007) [35] | Brazil N = 72 36 exposed/ 36 unexposed | Radiology Units (physicians, technicians) | DOE to IR (6.5 ± 5.0 years) | CA (chromatid breaks, chromosome breaks, exchange figure) MN | MN: 6.13 ± 3.18 (E); 5.11 ± 3.85 (NE) CA: 2.60 ± 2.00 (E); 2.30 ± 1.80 (NE) | 5 |
Djokovic et al. (2016) [36] | Serbia N = 65 Cohort | Nuclear Medicine Centre | Badge doses | CA (dicentrics, acentrics, rings, chromatid lesions, isochromatid lesions) | No significant difference for dicentrics, rings, chromatid lesions between the initial and periodical medical examinations (during exposure), but significant increase of acentric fragments | 6 |
Dobrzynska et al. (2014) [37] | Poland N = 86 46 exposed/ 40 unexposed | Nuclear Medicine Oncological Endocrinology (doctors, nurses, technicians, radiochemists and administrative staff) | Badge doses (0.3 ± 0.2 mSv/year) DOE to IR (8.5 ± 6.7 years) | TM % DNA | TM: 0.90 ± 1.09 (E); 0.30 ± 0.44 (NE) %DNA: 1.60 ± 1.50 (E); 0.78 ± 0.54 (NE) | 6 |
Doukali et al. (2017) [38] | Tunisia N = 64 29 exposed/ 35 unexposed | Radiotherapy Radiology departments | DOE to IR (8.8 ± 4.1 years in Group I, 20.1 ± 4.7 years in Group II) | MN SCE | MN: 1.16 ± 0.65 (E); 0.46 ± 0.21 (NE) SCE: 8.47 ± 0.45 (E); 7.22 ± 0.82 (NE) | 4 |
Eken et al. (2010) [39] | Turkey N = 70 40 exposed/ 30 unexposed | Radiology unit (physicians, technicians) | Badge doses (median = 0.17 (range 0.10–3.86 in the last 6 months) | MN SCE | MN: 6.88 ± 2.54 (E); 5.50 ± 2.00 (NE) SCE: 6.86 ± 0.44 (E); 6.70 ± 0.53 (NE) | 7 |
El-Benhawy et al. (2016) [40] | Egypt N = 90 60 exposed/ 30 unexposed | Radiotherapy Diagnostic radiology Industrial radiographers | Badge doses (2.9 ± 1.9 mSv/year in radiologists, 3.1 ± 1.5 mSv/year in radiotherapists) | CA (gaps, breaks, fragments and dicentrics) | All types of CA in (E) significantly higher than in (NE) | 6 |
Engin et al. (2005) [41] | Turkey N = 75 20 + 33 exposed/ 22 unexposed | Radiotherapy Radio-diagnostic | Badge doses DOE to IR (11.2 ± 0.8 years in X-ray group, 6.5 ± 0.9 in γ-rays group) γ-rays and X-rays | SCE | 10.50 ± 0.41 (E); 4.17 ± 0.32 (NE) | 4 |
Fang et al. (2019) [42] | China N = 334 175 exposed/ 159 unexposed | Badge doses (38.4 ± 27.4 mSv) X-ray radiation | CA (dicentrics, ring, and acentric fragments) MN % DNA TM & Olive TM | MN, CA, %DNA, TM significantly greater for (E) compared to (NE) | 8 | |
Gaetani et al. (2018) [43] | Italia N = 248 116 exposed/ 132 unexposed | Department of Nuclear Medicine Radiology Interventional Radiology Oncological Radiotherapy (doctors, nurses, technicians and radiochemists) | Badge doses (1.9 ± 1.6 mSv in group with accumulated IR dose <6 mSv; 34.0 ± 30.4 in group with accumulated IR dose >6 mSv) | DNA SBs | No difference in SBs frequencies between IR dose groups | 6 |
Gao et al. (2020) [23] | China N = 336 218 exposed/ 118 unexposed | Diagnostic radiology Radiotherapy Interventional radiology Nuclear medicine (technicians, physicians and nurses) | Badge doses (median = 0.5 mSv (IQR = 0.4–0.7)) | MN | MN (median, IQR): 3 (1, 5) (E); 2 (0.75, 4) (NE)) | 7 |
Garaj-Vrhovac et al. (2003) [44] | Croatia N = 100 50 exposed/ 50 unexposed | Radiology Surgery | Badge doses (range 0–8548 μSv in the previous year) | TL TM | TL: 14.85 ± 0.21 (E); 11.46 ± 0.15 (NE) TM: 17.49 ± 0.23 (E); 14.05 ± 0.13 (NE) | 5 |
Gerić et al. (2019) [45] | Croatia N = 48 24 exposed/ 24 unexposed | Badge doses (1.8 ± 3.6 mSv over the last year) X-rays | MN NPB TL %DNA | MN: 5.74 ± 3.89 (E); 5.38 ± 2.63 (NE) NPB: 1.61 ± 1.08 (E); 1.38 ± 1.65 (NE) TL: 15.46 ± 1.47 (E); 14.05 ± 1.36 (NE) %DNA: 1.57 ± 0.47 (E); 1.49 ± 0.89 (NE) | 6 | |
Gharibdousty et al. (2017) [24] | Iran N = 70 35 exposed/ 35 unexposed | (Radiopharmacists) | Badge doses (6.6 ± 5.8 mSv in the last year) | MN NPB | MN: 25.82 ± 8.67 (E); 10.52 ± 6.83 (NE) NPB: 1.02 ± 0.02 (E); 0.85 ± 0.37 (NE) | 6 |
Ha et al. (2002) [46] | Korea N = 176 Cross sectional | 144 workers in two nuclear power plants 32 workers in one university hospital | Badge doses (0.9 ± 1.3 cGy for hospital workers) | Glycophorin A mutant assay (NO or NN variants) | NO variant: β = 1.88 (p = 0.003) NN variant: β = 2.23 (p = 0.0001) | 3 |
Joseph et al. (2004) [47] | India N = 73 46 exposed/ 27 unexposed | Nuclear Medicine | Badge doses (range 0.25–62.9 mSv) | MN | 9.80 ± 6.20 (E); 7.00 ± 3.80 (NE) | 6 |
Jovicic et al. (2009) [48] | Serbia N = 94 30 exposed/ 64 unexposed | Badge doses DOE to IR (years) X-ray | CA (chromatid and chromosome breaks, acentrics, dicentrics and rings) | Aberrant cells: 3.40 ± 1.80 (E); 0.80 ± 0.90 (NE) | 6 | |
Jovicic et al. (2010) [49] | Serbia N = 53 30 exposed/ 23 unexposed | Badge doses (13.3 mSv (range 4.81−24.76)) DOE to IR (12.7 ± 7.4 years) X-rays | CA (chromatid and chromosome breaks, acentrics, dicentrics and rings) PCD | CA and PCD significantly higher in (E) compared to (NE) (except rings) R Total life effective dose-PCD = 0.71 (p < 0.001) | 6 | |
Kasuba et al. (2008) [50] | Croatia N = 785 765 exposed/ 200 unexposed | Anesthesiologists, anesthetic technicians, radiology technicians, operating room nurses, surgeons, nurses, radiologists, and urologists/gynecologists | DOE to IR (12.1 ± 8.40 to 15.8 ± 9.8 years) | CA (dicentrics and rings, acentric fragments, and tri- and tetra-radial exchanges) | CA significantly higher in (E) compared to (NE) (except rings) | 5 |
Khisroon et al. (2015) [51] | Pakistan N = 144 74 exposed/ 70 unexposed | Radiology personnel | DOE to IR (7.8 ± 5.3 years) | CS | CS: 129.8 ± 17.2 (E); 53.0 ± 25.0 (NE) R DOE-CS = 0.62 (p < 0.001) | 6 |
Kopjar et al. (2005) [52] | Croatia N = 120 60 exposed/ 60 unexposed | Nuclear medicine physicians, technical experts, engineers, nurses, cleaners | Badge dose (196 µSv (range 0–1401) Radionuclides (dominantly 131I and 99mtc) | TL CA (number of sister chromatids and breakage events) | TL: 21.44 ± 0.14μm (E); 13.96 ± 0.02μm (NE) CA mean: 2.37 ± 0.16 (E); 0.85 ± 0.09 (NE) Aberrant cells: 1.15 ± 0.08; 0.23 ± 0.06 (NE) | 6 |
Kumar et al. (2016) [53] | India N = 134 83 exposed/ 51 unexposed | Diagnostic or therapeutic radiation facilities | Badge doses DOE to IR (6.5 ± 0.7 years) | MN CA (aneuploidy, acentric fragments) | CA and MN frequencies significantly higher in (E) compared to (NE) | 5 |
Lalic et al. (2001) [54] | Croatia N = 45 25 IR-exposed/ 20 non-IR exposed | (Medical radiology, X-rays technicians, nurses) | Badge doses | CA (chromatid and chromosome breaks, acentric fragments, dicentrics) | Total number of CA: 4.08 ± 0.37 (E); 4.35 ± 0.50 (NIR) R with 6-years exposure dose = 0.62 | 4 |
Little et al. (2014) [55] | USA N = 238 Cohort | USRT study CTS-I: inclusions in 1994–1995 CTS-II: inclusions in 2003 | Estimated cumulative personal-diagnostic-medical Occupational red bone marrow radiation dose scores | FISH for translocations | Translocation rates in relationship to occupational and personal-diagnostic-medical (PDM) doses = 7.0 (95% CI 1.2, 12.9) × 10−2 translocations Gy−1 | 7 |
Maffei et al. (2002) [56] | Italy N = 74 37 exposed/ 37 unexposed | (Physicians and technicians) | Badge doses (35.1 ± 40.8 mSv) X and γ-rays | MN | MN: 6.78 ± 4.92 (E); 5.54 ± 2.99 (NE) | 6 |
Maffei et al. (2004) [57] | Italy N = 69 34 exposed/ 35 unexposed | (Physicians and technicians) | Badge doses (35.8 ± 38.9 mSv) X and γ-rays IR-exposure for at least 3 years | CA (chromatid breaks, chromatid exchanges, chromosome breaks and chromosome exchanges) | Aberrant cells: 2.87 ± 3.10 (E); 1.08 ± 1.03 (NE) | 6 |
Maluf et al. (2001) [58] | Brazil N = 44 22 exposed/ 22 unexposed | Badge doses (range 0.2–121.8 mSv) X-rays | MN NPB CS | MN: 8.84 ± 2.35 (E); 7.18 ± 2.59 (NE) NPB: 2.98 ± 1.57 (E); 1.96 ± 1.04 (NE) CS: 17.73 ± 10.51 (E); 8.54 ± 7.11 (NE) | 6 | |
Martínez et al. (2010) [59] | Mexico N = 61 41 exposed/ 20 unexposed | Nuclear Medicine Radiotherapy Radiology | Badge doses (0.21 ± 0.02 mSv/month, 0.4 ± 0.2 mSv/month, 0.17 ± 0.02 in Nuclear Medicine, radiotherapy, and radiology departments respectively) | TL | Radiology: 28.6 ± 3.50 (E); 15.2 ± 1.92 (NE) Nuclear: 92.5 ± 19.02 (E); 15.2 ± 1.92 (NE) Radiotherapy: 63.4 ± 15.4 (E); 15.2 ± 1.92 (NE) | 4 |
Milacic et al. (2005) [60] | Serbia and Montenegro N = 68 46 exposed/ 22 unexposed | Badge doses (7.9 ± 5.0 mSv) DOE to IR (10.6 ± 6.4 years) X-rays IR-exposure for at least 3 years | CA (dicentrics, rings and acentric fragment, breaks, exchanges) | CA frequencies correlate with absorbed doses. During breaks of exposure, number of damaged cells decreased Time necessary for aberrations to disappear not in relation with former frequency of aberrations or DOE and absorbed dose | 5 | |
Milic et al. (2015) [61] | Croatia N = 147 77 exposed/ 70 unexposed | DOE to IR (13.7 ± 8.9 years) | MN NPB | MN: 16.20 ± 10.40 (E); 11.50 ± 9.40 (NE) β = 0.403 (p = 0.003) NPB: 0.90 ± 1.50 (E); 1.70 ± 4.00 (NE) β = 0.024 (p = 0.230) | 6 | |
Movafagh et al. (2007) [62] | Iran N = 93 50 exposed/ 43 unexposed | Radiotherapy | Badge doses X-rays IR-exposure for at least 5 years | CA (Dicentrics, Fragments and Rings) | Total CA: 3.40 ± 1.18 (E); 2.00 ± 0.82 (NE) | 6 |
Mrdjanovic et al. (2005) [63] | Serbia-Montenegro N = 45 30 exposed/ 15 unexposed | Radiotherapy Cardiology | DOE to IR (11.9 ± 9.04 years) | SCE MN | MN for Radiology group: 15.00 ± 9.39 (E); 9.06 ± 3.23 (NE) SCE: no significant difference between (E) and (NE) | 5 |
Pajic et al. (2016) [64] | Serbia N = 90 50 exposed/ 40 unexposed | Badge doses (9.9 ± 6.8 mSv in last 5 years) DOE to IR (18.0 ± 8.1 years) Radionuclides (Y90 and I131) | CA (chromatid and isochromatid breaks, acentrics, dicentrics and rings) MN PCD | MN (ratio per number of analyzed cells): 1/48.26 (E); 1/117.3 (NE) Dicentrics (ratio): 1/1600 (E); 1/303.03 (NE) Acentrics (ratio): 1/533 (E); 1/75.75 (NE) Chromatid breaks (ratio): 1/615 (E); 1/294 (NE) Isochromatid breaks (ratio): 1/1143 (E); 1/400 (NE) PCD (ratio): 1/800 (E); 1/94.33 (NE) R for DOE-aberrant cells = 0.77 R for DOE-MN = 0.82 R for DOE-PCD = 0.65 | 5 | |
Pajic et al. (2017) [65] | Serbia N = 402 201 exposed/ 201 unexposed | Radiology | DOE to IR (15.1 ± 7.4 years) X-rays | MN NPB | MN: 15.15 ± 5.82 (E); 8.31 ± 3.88 (NE) NPB: 0.75 ± 0.85 (E); 0.23 ± 0.47 (NE) | 7 |
Pakniat et al. (2016) [66] | Iran N = 40 20 exposed/ 20 unexposed | Radiology CT scan | Badge doses | CS | No significant difference between (E) and (NE) at baseline After irradiation by 4mGy, DNA damage frequencies significantly lower in (E) compared to (NE) | 4 |
Qian et al. (2016) [67] | China N = 1535 1392 exposed/ 143 unexposed | Radiodiagnostic Radiotherapy | Badge doses (13.7 mSv (range 0.2–19.8)) | MN CA (dicentric, centric ring, and acentric fragment, translocation, inversion, insertion, and deletion) with FISH | Frequencies of CA and MN rates in (E) significantly higher than (NE) (0.68 vs. 0.22%, and 2.44 vs. 1.72‰ respectively) | 6 |
Raavi et al. (2016) [68] | India N = 150 20 exposed/ 130 unexposed | Radiology (physicians, staff) | Badge doses (range 0.02–0.40) | γ-H2AX foci | Mean γ-H2AX foci: 0.066 ± 0.005 (E); 0.042 ± 0.001 (NE) | 5 |
Ropolo et al. (2012) [69] | Italy N = 60 30 exposed/ 30 unexposed | Badge doses (19.5 ± 37.59 mSv) DOE to IR (12.5 ± 9.5 years) X- and gamma-radiation | MN NPB | MN: 3.87 ± 2.14 (E); 3.66 ± 1.68 (NE) NPB (median (range)): 0.50 (0–2.75) (E); 0.75 (0–2.25) (NE) | 5 | |
Sahin et al. (2009) [70] | Turkey N = 21 “auto-controls” | Nuclear medicine | Badge doses (4.0 ± 10.2 mSv in last year) Occupational radiation exposure between two vacations and after 1 month of vacation either following or before occupational exposure | MN SCE | MN: 21.90 ± 1.71 (AE); 14.13 ± 1.25 (BE) SCE: 7.52 ± 0.27 (AE); 6.25 ± 0.17 (BE) | 5 |
Sakly et al. (2012) [71] | Tunisia N = 64 31 exposed/ 33 unexposed | Radiology | DOE to IR (13.7 ± 9.4 years) | TL | 24.98 ± 1.07 µm (E); 22.44 ± 0.57 µm (NE) | 6 |
Sakly et al. (2013) [72] | Tunisia N = 87 60 exposed/ 27 unexposed | Radiology Cardiology | DOE to IR (16.5 ± 10.2 years, 12.3 ± 9.4 years in radiology and cardiology departments respectively) | MN CA (gaps, simple-strand breaks and double-strand breaks, reciprocal translocations, rings, and dicentrics) | MN in Radiology: 21.90 ± 4.23 (E); 10.78 ± 1.47 (NE) MN in Cardiology: 25.57 ± 4.79 (E); 10.78 ± 1.47 (NE) CA in Radiology: 33.63 ± 4.40 (E); 14.26 ± 3.40 (NE) CA in Cardiology: 35.37 ± 5.19 (E); 14.26 ± 3.40 (NE) | 5 |
Santovito et al. (2014) [73] | Italy N = 42 21 exposed/ 21 unexposed | Radiology | - | CA (chromatid breaks, chromosome breaks, dicentrics, acentric fragments, and Tri- or Tetra-radials, Gaps) SCE | Aberrant cells: 2.07 ± 0.17 (E); 1.17 ± 0.17 (NE) β = −0.08 (95% CI −2.22;3.76) per years of employment SCE: 6.67 ± 0.29 (E); 4.49 ± 0.39 (NE) β = 0.26 (95% CI −8.07;10.32) per years of employment | 5 |
Sari-Minodier et al. (2007) [74] | France N = 201 132 exposed/ 69 controls | Radiotherapy Nuclear medicine Cardiology Radiology Pediatric operating room | Badge doses (0.17 ± 0.47 mSv in the last year) + Estimated medical radiation dose as a patient | MN | 14.90 ± 8.10 (E); 11.80 ± 6.50 (NE) β = 2.55 (95% CI 0.57;4.53, p = 0.012) (increase for (E) people vs. (NE)) | 6 |
Scarpato et al. (2006) [75] | Italy N = 92 Cross-sectional | Orthopedic Radiology Cardiology | Badge doses (3.3 ± 5.6 mSv in the last 3 years) IR-exposure for at least 3 years | CA (breaks or fragments, quadri-radial and triradial, translocations, dicentrics and rings) | Total CA: 1.79 ± 0.23 (HE); 1.37 ± 0.24 (ME); 1.32 ± 0.19 (LE) | 5 |
Shafiee et al. (2020) [76] | Iran N = 81 46 exposed/ 35 unexposed | Lithotripsy CT scan Digital radiology | Badge doses (range 0–2.99 mSv in the last year) | MN CA (acentric fragments, gap, rings, and dicentrics) | MN: 6.89 ± 2.25 (E); 5.17 ± 1.70 (NE) R with cumulative radiation dose = 0.98 (p = 0.02) Significantly higher frequencies of CA in (E) compared to (NE) (except dicentrics and rings). R with cumulative radiation dose = 0.97 (p = 0.02) | 6 |
Siama et al. (2019) [77] | India N = 66 33 exposed/ 33 unexposed | Radiology | Badge doses (40.9 ± 39.9 mSv) DOE to IR (10.3 ± 7.1 years) | MN | Significant rise in MN frequency in (E) compared to (NE) β = 0.42 (p = 0.02) per years of employment | 6 |
Silva et al. (2016) [78] | Brazil N = 90 45 exposed/ 45 unexposed | (Radiologists, technologists and technicians) | X-rays | CS | Significantly higher damages (minimum to maximum levels) in (E) compared to (NE) Significantly lower cells with no damage in (E) compared to (NE) R with time of work = 0.637 (p = 0.001) | 5 |
Surniyantoro et al. (2018) [79] | Indonesia N = 101 81 exposed/ 20 unexposed | Radiology Radiotherapy (doctors, radiologists, radiotherapists, and nurses) | Badge doses (0.2 ± 0.2 mSv/year) DOE to IR (20.8 ± 7.5 years) | MN | 15.38 ± 7.72 (E); 9.00 ± 5.49 (NE) β = 0.05 (p = 0.69) | 5 |
Thierens et al. (2000) [80] | Belgium N = 131 71 exposed/ 60 unexposed | Radiology Radiotherapy Nuclear Medicine Cardiology Urology Gastroenterology (doctors, nurses or technicians) | Badge doses (20.8 ± 7.5 mSv) | MN | 21.88 ± 13.46 (E); 18.36 ± 7.53 (NE) | 6 |
Tug et al. (2013) [81] | Turkey N = 74 39 exposed/ 35 unexposed | (Radiology technologists) | - | SCE | 5.19 ± 1.06 (E); 3.38 ± 1.13 (NE) | 4 |
Vellingiri et al. (2014) [82] | India N = 112 56 exposed/ 56 unexposed | Radiology Cardiology Orthopedic (nurses, technicians, physicians) | Badge doses (range 1.3–24.5 mSv) DOE to IR (years) | CA (dicentrics or unusual karyotypes and structural CA) MN TL TM | Significantly higher CA and MN frequencies, TL and TM in (E) compared to (NE) | 7 |
Vral et al. (2016) [83] | Belgium N = 38 29 exposed/ 19 unexposed | Nuclear medicine Interventional radiation | Badge doses (Hp(10) 4.95 ± 2.00 mSv over the last year in Nuclear Medicine department) | MN | No significant difference between (E) and (NE) | 6 |
Wang et al. (2017) [84] | Japan N = 530 Cross sectional | Badge doses (means from 0.4 to 1.7 mSv/year) | CA (Chromosome breaks, fragments and dicentrics) MN | No significant difference in CA and MN between years of service groups, except significantly higher CA in female with >20 years compared to lower classes | 4 | |
Zakeri et al. (2003) [85] | Iran N = 508 450 exposed/ 58 unexposed | (Industrial radiographers, nuclear research center, nuclear medicine workers, medical X-ray diagnostic workers) | - | CA (dicentrics, rings and acentrics) | Acentrics and dicentrics significantly higher in the different job-groups of (E) compared to (NE) | 5 |
Zakeri et al. (2004) [86] | Iran N = 107 71 exposed/ 36 unexposed | Cardiovascular laboratory (cardiologist, nurses and technicians) | Badge doses (range 0.25–15 mSv/year) DOE to IR (11 ± 7 years) X-rays | CA (dicentrics, and acentrics) MN | MN: 38.91 ± 15.58 (E); 11.05 ± 4.51 (NE) CA: 6.73 ± 2.23 (E); 1.0 ± 0.5 (NE) | 6 |
Zakeri et al. (2010) [87] | Iran N = 136 101 exposed/ 35 unexposed | (Interventional cardiologist, nuclear medicine physicians, conventional radiologists) | Badges doses (range 0.25–48 during the previous year) | CA (gap, isogap, break, minute, fragment, dicentric) MN | MN: 21.5 ± 9.6 (IC); 19.7 ± 3.8 (NM); 16.8 ± 8.1 (CR); 11.8 ± 6.5 (NE) %acentrics: 3.23 ± 2.60 (IC); 2.87 ± 1.40 (NM); 2.18 ± 0.90 (CR); 1.28 ± 0.50 (NE) %dicentrics: 0.21 (IC); 0.14 (NM); 0.13 (CR); 0.04 (NE) | 6 |
Zakeri et al. (2010) [88] | Iran N = 74 37 exposed/ 37 unexposed | (Interventional cardiologists, clinical physicians) | Badges doses (8.1 ± 7.8 mSv/year; 30.5 ± 24.3 over the last 5 years) | CA (Chromatid and chromosome breaks, gaps, dicentrics and centric rings) | Aberrant cells: 2.78 ± 1.63 (E); 1.27 ± 1.07 (NE) | 5 |
Zhou et al. (2016) [89] | China N = 127 52 exposed/ 75 unexposed | Radiology Cardiology (radiologic technologist, radiologist, and interventional cardiologist) Participants with cataract | DOE to IR (9.3 ± 2.8 years) | CA (dicentrics, tricentrics, structural) | 1.77 ± 0.92 (E); 0.63 ± 0.51 (NE) | 4 |
Endpoints | Number of Studies Carried Out on These Endpoints | Is This Biomarker Recommended for Use in Future Prospective Epidemiological Studies to Examine Their Association with Long-Term Health Outcomes Following IR-Exposure? |
---|---|---|
Dicentrics | 24 | Yes |
Acentric fragments | 14 | Yes |
Micronucleus | 32 | Yes |
Rings | 14 | No |
Nucleoplasmic bridges | 7 | No |
Sister chromatid exchanges | 7 | ≈Yes |
Translocations | 6 | ≈Yes |
Comet tail length | 6 | ≈Yes |
Comet tail moment | 4 | ≈Yes |
Comet score (DNA damage extent) | 4 | ≈Yes |
Premature centromere divisions | 2 | ? (Yes) |
Glycophorin A (GPA) mutant | 1 | ? (Yes) |
Leukocyte telomere length | 1 | ? (Yes) |
Copy number variation in AZFc region | 1 | ? (Yes) |
%DNA in the tail | 3 | ? (Yes) |
γ-H2AX foci | 1 | ? (Yes) |
Endpoints | Sensitivity | Specificity to IR |
---|---|---|
Dicentrics | 50–100 mGy | High |
Translocations | 200–300 mGy | Good |
Micronuclei | 100–200 mGy | Good |
Comet assay | 50–100 mGy | Low |
γ-H2AX foci | 10 mGy | Good |
Leukocyte telomere length | unknown | Low |
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Baudin, C.; Bernier, M.-O.; Klokov, D.; Andreassi, M.G. Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses. Int. J. Mol. Sci. 2021, 22, 7504. https://doi.org/10.3390/ijms22147504
Baudin C, Bernier M-O, Klokov D, Andreassi MG. Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses. International Journal of Molecular Sciences. 2021; 22(14):7504. https://doi.org/10.3390/ijms22147504
Chicago/Turabian StyleBaudin, Clémence, Marie-Odile Bernier, Dmitry Klokov, and Maria Grazia Andreassi. 2021. "Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses" International Journal of Molecular Sciences 22, no. 14: 7504. https://doi.org/10.3390/ijms22147504