الفهرس 
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Abstract
Radiation is defined as energy traveling through space. It is of two main types, namely; non-ionizing and ionizing radiation, non-ionizing radiation includes: infra-red radiation, microwaves, low frequency electrical and magnetic fields. Ionizing radiation includes; electromagnetic radiation (X and Gamma rays) and particulate radiation which includes; (Alpha, Beta and Neutrons). In radiation working places occupational workers, e.g., Physicians, Physicists, Technicians, Nurses, Workers and Minor Workers (Administrators and Managerial staff) may be exposed to different sources of radiation that are used in diagnoses and in radiation therapy. In diagnoses; X- rays, CT and Gamma Camera machines are mainly used where during diagnoses, specially, The Gamma Camera, uses Thallium-201 and Tc-99. In radiation therapy, sources such as Co-60
(of half live ≈ 5 years), Cs-137 (of half-life ≈ 30 tears) in addition to linear accelerators of high energy photons (> 6 MV and electrons of > 6 MeV) are used in therapy. During the routine work of these sources occupational workers may be exposed to high levels of radiations, especially, in case of uncontrolled sources, so the workers may be suffered from some biological effects.
Accordingly, the aim of this work was to “Study Some Hematological, Biophysical and Biochemical Parameters in Blood of Occupational Radiation Workers “. For this purpose, the study includes 45 subjects divided into two main groups, the first group consists of 15 control subjects that are free from any apparently diseases. The second group consists of 30 subjects in radio therapy radiation place as; workers, nurses and doctors in one of Alexandria City, at Alexandria Ayadi Al-Mostakbl Oncology Center (AAAOC) from the period 2007 to
2018. The radiation doses received by these occupational workers and the CBC of them were documented through the period from 2007 – 2018 and used as base line in addition some hematological and biochemical tests which added including; oxidative stress parameters, liver and kidney parameters from the period of 2015 -2018.
With respect to the Hematological parameters, the results of the hematological variations, in general, started with the higher values of RBCs in nurses group and declined from about 6 million to the lowest level of about 4.3 million during 2014 to start to increase since 2018 upwards, to reach about 4.9 million at the end of the considered period. The other groups followed minor fluctuations in RBCs during the whole period.
Hb concentrations: The nurse group started with minimum value of about 11 g/dl to increase steadily upwards to enter the lower normal Hb level of 12.5 g/dl beginning from 2011 upwards. The workers started with a normal level of about 13 g/dl to decline to a minimum level of 11.5 g/dl during 2011, 2012 and 2014, and started to increase upwards. The remainder groups showed minor fluctuations around 13.5 g/dl to reach the maximum value of about 14.5 g/dl on 2018.
The Hematocrit Values: Followed inverse variations that occurred in Hb with nurses and workers, where the nurse group started with higher value of about 40% to decrease steadily to a minimum value of about 36% on 2010 and 34% on 2014 to increase upwards to enter the normal Hb level of 41% 2018. The workers started with a level of about 35% to increase to a level of about 38% during 2010, 2011and started to decrease during 2013, 2014 and increased upwards to a value of 38% on
2018. The remainder groups showed minor fluctuations around 40% to reach the maximum value of about 42% on 2018.
The MCV: No sudden changes in these values occurred except in the nurse group to reach a lowest value of about 69 fl on 2012. The remaindered groups showed fluctuations about 80 fl, i.e. in the normal range.
The MCH: Started in the worker group with the lowest value of about 25 pg to star to increase steadily to join the other groups with minor fluctuations to reach a value of about 28 pg on 2017 to decline again to nearly its starting level.
The same alterations occurred with MCHC, with the starting minimum value of about 32 g/dL with the worker group, with the remainder groups fluctuate around 34 g/dL.
The Platelets: The nurse group started with the highest value of about 408,000 count/ml to reach its minimum level at about 280,000 count/ml on 2011, 2012 and 2014 and increase upwards to the level of about 333,000 count/ml on 2018. The technicians started with the minimum value of all the groups at about 200,000 count/ml, to increase upwards to reach a value of about 250,000 count/ml on 2018. The other groups fluctuated around 280,000 count/ml.
The WBCs: The studied groups started with about 6,000 counts with the worker group to increase and a higher level of 8,000 count with the physician group to decrease slightly to reach a value of about 7.500 with all the groups with minor fluctuations around this value on 2018.
The RDW-CV: The variation in the normal range of this parameter indicates variation in the RBCs volume which indicates a nutrient deficiency, infection, or other disorder. The workers mean value started with about 16 fL and that of nurses with about 15 fL to decline steadily to minimum values of about 13 fL during and 2010 and 2011 and starting to increase upwards till value of about 14 fL on 2018, while the other groups showed minor fluctuations around 13fL.
With respect to the oxidative stress parameters, including TAC, and MDA showed no significant changes with respect to the control levels with minor fluctuations except in case of the technician’s group which suffered higher changes on 2015 and 2017, but within the normal levels.
Also, Albumin, Globulin, and Total Protein showed normal levels in all groups, with the nurses group showed the higher levels, but still within the control. This indicates that these group of radiation workers do not suffer any problems in the liver functions.
Elemental concentrations variations: The role of some minerals in the body is important in regulating the amount of fluids in the body, such as potassium, side by side with sodium which causes retention of fluids in case of high concentrations of sodium, leading to hyper tension. The concentrations of both potassium and sodium showed normal ranges with minor fluctuations in case of potassium than sodium. Relatively higher levels during 2015 until 2018, were recorded in the workers group, followed by both of nurse and the technician groups with the lowest levels in the physician and physicist groups. Since these two elements are controlled by the kidneys, so their levels do not give any
indication of kidneys disturbances in the five considered categories of radiation workers.
Calcium: is important for maintenance of strong bones and teeth, in addition to other processes in the body such as blood clotting, heart beating, and muscles and nervous system functions. The calcium showed minor variations in all the five groups of workers, indicating no sever problems in the bones or teeth.
The Chloride Ion and chloride salts, i.e., sodium chloride is responsible for acid/base maintenance balance, controlling fluid out and in the cells, and nerve impulses transitions. The group of workers showed the highest levels of chloride with respect to the other groups which showed moderate fluctuations. However, all groups didn’t show differences with respect to the normal levels.
Iron concentrations: The concentrations of this element in all the studied groups showed minor fluctuations, but still in the control ranges, indicating that all these occupational workers did not suffer from anemia, except with the workers category at the beginning of catching work in the radiation field. The level of the iron increased steadily afterwards to reach the control levels starting from 2011 upwards.
Final comment: No significant differences were found between the studied groups and the control group, with minor changes during 2015-2018. However, most the variations recorded in the CBCs of the occupational workers followed reducing effects from 2007 until 2010-2011 then started to increase slowly towards a recovery path towards higher levels, i.e., normal levels. In our opinion, and according to some
opinions in literature (Wolff, 1998; Calabrese, et al, 2003; Kaiser, 2003; Feinendegen, 2005; Allison, Wade, 2009), The recovery obtained in the radiation may be due to the beneficial effects of background radiation which tends to repair the damage or risk It is also of value to mention that to trace the effects of background radiation on large scale.
It must be mentioned that the data of the present work reveled that the two categories i.e. nurses and workers were the only two categories that suffering from relatively high fluctuation in the measured parameters. This may be due to that these two categories of workers are more exist in the radiation room and more adjacent to the patients throw nursing and housekeeping. This increases the probability of more exposure to radiation during patient’s services.