Background. Ionizing Radiations (IR) are an important occupational risk factor for the potential damage that can cause to workers' health and for their presence in numerous professional settings. Health care workers (HCW) can be exposed to IR from various sources, in particular from x-rays using radiological equipment, and represent the largest group of workers occupationally at risk, despite increased regulation and protection which caused exposure to low dose radiations. The thyroid gland is one of the most sensitive organs to damage and an important target of IR, leading to functional and organic diseases. The aim of this study is to assess the variations in thyroid hormones, in a population of HCW exposed to low-dose IR. Methods. 121 individuals of the Teaching Hospital Policlinico Umberto I in Rome exposed to low-dose of IR (78 HCW, 17 Residents and 26 Radiology Technicians Students) were observed assessing serum levels of different thyroid function parameters as free triiodothyronine, free thyroxine and thyroid stimulating hormone at T1, T2 and DeltaT. Age, gender, history of thyroid diseases, BMI and smoke were analyzed as possible influencing factors using linear and multiple logistic regression analysis. Results. Analyzing TSH, fT3 and fT4 serum levels, in two different measurement (T1 and T2) and considering Delta between them, adjusting for different confounding factors, data showed no variation of TSH levels related to occupational exposure, a decrease of fT3 hormone values in HCW and residents, and an increase of fT4 in HCW. Discussion. The analysis of our results revealed that hospital occupation has an impact on thyroid hormones variations, with an increase of fT4 and a decrease of fT3 and no variations of TSH. These results are in conflict with previous studies evidences, in which both free hormones decreased with a concomitant increase of TSH. Conclusion. Exposure to low dose IR influences levels of free thyroid hormones, with no variation in TSH, which could result in a functional or organic disease. For this reason it is recommended continuous surveillance through a periodic check of all the thyroid hormones for an overall view of each HCW. However, further studies are necessary to confirm hormones trend and assess any related thyroid diseases.
Keywords: TSH; fT3; fT4; healthcare workers; ionizing radiations.
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