Tesis

Pengaruh Paparan Radiasi Pengion terhadap Risiko Katarak pada Pekerja Radiasi bidang Kardiologi Intervensi di Indonesia = Effects of Ionizing Radiation Exposure on Cataract among Radiation Workers of Interventional Cardiology in Indonesia.

Tujuan: menilai prevalensi katarak terinduksi radiasi, serta menghubungkannya dengan dosis paparan radiasi dan penggunaan perlengkapan proteksi radiasi. Metode: Studi potong lintang dan studi kasus-kontrol. Seratus delapan puluh subyek berpartisipasi dalam penelitian. Prevalensi katarak terinduksi radiasi dinilai menggunakan analisis Scheimpflug pada alat Pentacam®-Oculus. Dosis paparan radiasi kumulatif dan penggunaan perlengkapan proteksi radiasi pada subyek diidentifikasi melalui kuesioner dan personal dosimeter. Hasil: Prevalensi katarak terinduksi radiasi sebanyak 16.7%. Median dosis radiasi kumulatif berdasarkan kuesioner menunjukkan median 0,8 (0.1– 35.6) Gy. Hubungan korelasi positif didapatkan antara dosis radiasi kumulatif dengan densitas lensa (R Spearman= 0.64). Sebanyak 83.9% subyek menggunakan tabir pada 71-100% masa kerjanya, tetapi mayoritas subyek penelitian (40.6%), tidak menggunakan kacamata pelindung. Peningkatan risiko katarak terinduksi radiasi meningkat secara bermakna seiring dengan kepatuhan penggunaan proteksi radiasi yang kurang. Subyek dengan proteksi tabir radiasi 31-50% dari masa kerjanya meningkatkan risiko katarak 10.80 kali lipat (IK 95% 1.05–111.49, p=0.044). Sementara itu, kelompok proteksi tabir radiasi 51-70% meningkatkan risiko katarak 8.64 kali lipat (p=0.001). Subyek yang tidak memakai kacamata pelindung memiliki OR 164.3 (IK 95% 19.81–1363) dibandingkan dengan kelompok pengguna kacamata pelindung. Kesimpulan: Katarak terinduksi radiasi pada pekerja radiasi bidang kardiologi intervensi tergantung pada dosis paparan radiasi dan penggunaan proteksi radiasi. Oleh karena itu, kepatuhan pekerja radiasi perlu ditingkatkan sesuai ketentuan proteksi radiasi.
Kata kunci: pekerja radiasi, kardiologi intervensi, katarak terinduksi radiasi, dosis radiasi, tabir radiasi, kacamata pelindung.


Objectives: to determine the prevalence of radiation-induced cataract and correlate with radiation exposure dose and radiation protection use among radiation workers of interventional cardiology. Methods: A cross-sectional and retrospective case-control study. One hundred and eighty subjects were included. Prevalence of radiation-induced cataract was assessed using Scheimpflug analysis on the Pentacam®-Oculus. Individual cumulative radiation exposure dose and radiation protection use of subjects were identified from questionnaire and personal dosimeter. Results: The prevalence of radiation-induced cataract was 16.7%. Median cumulative radiation dose was 0.8 (0.1-35.6) Gy. A positive correlation was found between cumulative radiation dose and lens density (RSpearman=0.64). This study showed that 83.9% of subjects used ceiling-suspended shield in 71-100% of their working period, however the majority of subjects (40.6%) did not wear protective eyewear. Statistically significant increasing risk of cataract was found along with unresponsive use of radiation protection. The subjects using ceiling-suspended shield in 31-50% of their working period were increasing their cataract risk by 10.80 times (95% CI 1.05- 111.49, p=0.044). Meanwhile, the subjects using protective eyewear in 51-70% of their working period were increasing their cataract risk by 8.64 times (p=0.001). Subjects who did not wear protective eyewear had an OR 164.3 (95% CI 19.81-1363) compared to those who wore protective eyewear. Conclusion: Radiation-induced cataract among radiation workers of interventional cardiology was depend on radiation exposure dose and radiation protection. Therefore, the compliance of radiation safety recommendation should be improved.
Keywords: radiation workers, interventional cardiology, radiation-induced cataract, radiation dose, ceiling-suspended shield, protective eyewear.