{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:03:47Z","timestamp":1791007427256,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["50445"],"award-info":[{"award-number":["50445"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nuclear Safety and Security Commission of the Republic of Korea","award":["50091"],"award-info":[{"award-number":["50091"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between cumulative radiation dose and haematological parameters among radiation workers and compare the prevalences of abnormalities in blood counts with those in the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      Nationwide radiation dose registry in Korea, linked with occupational health examination data. Cumulative doses were estimated using annual personal dose equivalent (H\n                      <jats:sub>p<\/jats:sub>\n                      (10)) records from 1984 onward.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study included 20\u2009414 radiation workers, comprising 17\u2009651 men (86.5%) and 2763\u2009women (13.5%), with baseline survey data, dosimetry records and at least one complete blood count (CBC) record between 2014 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>The primary outcome was the continuous haematological parameters, including white blood cell (WBC), platelet (PLT) and haemoglobin (Hb) counts, in relation to cumulative radiation dose. Associations were evaluated using linear mixed-effects models incorporating repeated measurements and adjusting for age, smoking status and body mass index. The secondary outcome was the prevalence of abnormal blood counts among radiation workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most haematological parameters among radiation workers were within normal ranges. In male workers, cumulative radiation dose was associated with increased Hb levels (\u03b2=0.5\u2009mg\/dL per 1\u2009mSv; 95%\u2009CI 0.006 to 0.9) after adjusting for age, smoking status and body mass index. No significant associations were observed between cumulative dose and WBC or PLT counts in either sex. Overall, compared with the general population, radiation workers had significantly lower standardised prevalence ratios for abnormal WBC and PLT counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No substantial adverse changes in haematological parameters were found among radiation workers exposed to prolonged low-dose radiation. The findings suggest that cumulative doses at occupational levels may not substantially affect CBC profiles, although continued monitoring and follow-up are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-098330","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:10:17Z","timestamp":1766725817000},"page":"e098330","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between cumulative radiation dose and haematological parameters among Korean radiation workers: a retrospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"Hyoju","family":"Sung","sequence":"first","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1755-5754","authenticated-orcid":false,"given":"Eun Shil","family":"Cha","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dal Nim","family":"Lee","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soojin","family":"Park","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Il","family":"Jang","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"},{"name":"Korea Cancer Center Hospital, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsu","family":"Cho","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Jin","family":"Ko","sequence":"additional","affiliation":[{"name":"Korea Cancer Center Hospital, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Dong","family":"Ju","sequence":"additional","affiliation":[{"name":"Korea Foundation of Nuclear Safety, Gyeonggi, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hye","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea Foundation of Nuclear Safety, Gyeonggi, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songwon","family":"Seo","sequence":"additional","affiliation":[{"name":"Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"2026010703523853000_15.12.e098330.1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/49.6.353"},{"key":"2026010703523853000_15.12.e098330.2","doi-asserted-by":"publisher","DOI":"10.1053\/jpan.2003.50013"},{"key":"2026010703523853000_15.12.e098330.3","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/bjh.15750","article-title":"Radiation exposure and longitudinal changes in peripheral monocytes over 50 years: the Adult Health Study of atomic-bomb survivors","volume":"185","author":"Yoshida","year":"2019","journal-title":"Br J Haematol"},{"key":"2026010703523853000_15.12.e098330.4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1269\/jrr.09081","article-title":"Longitudinal trends of total white blood cell and differential white blood cell counts of atomic bomb survivors","volume":"51","author":"Hsu","year":"2010","journal-title":"J Radiat Res"},{"key":"2026010703523853000_15.12.e098330.5","doi-asserted-by":"crossref","unstructured":"Guo J-J , Liu N , Ma Z , et al . Dose-Response Effects of Low-Dose Ionizing Radiation on Blood Parameters in Industrial Irradiation Workers. Dose Response 2022;20. doi:10.1177\/15593258221105695","DOI":"10.1177\/15593258221105695"},{"key":"2026010703523853000_15.12.e098330.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12199-021-00939-z","article-title":"Effects of exposure to low-dose ionizing radiation on changing platelets: a prospective cohort study","volume":"26","author":"Liu","year":"2021","journal-title":"Environ Health Prev Med"},{"key":"2026010703523853000_15.12.e098330.7","first-page":"465","article-title":"Professional exposure to ionizing radiations in health workers and white blood cells","volume":"24","author":"Caciari","year":"2012","journal-title":"Ann Ig"},{"key":"2026010703523853000_15.12.e098330.8","first-page":"1307","article-title":"Analysis of chromosomal aberrations frequency, haematological parameters and received doses by nuclear medicine professionals","volume":"21","author":"Djokovic-Davidovic","year":"2016","journal-title":"J BUON"},{"key":"2026010703523853000_15.12.e098330.9","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1093\/rpd\/ncac033","article-title":"THE INFLUENCE OF LOW-DOSE OCCUPATIONAL RADIATION EXPOSURE ON PERIPHERAL BLOOD CELLS IN A COHORT OF CHINESE MEDICAL RADIATION WORKERS","volume":"198","author":"Wang","year":"2022","journal-title":"Radiat Prot Dosimetry"},{"key":"2026010703523853000_15.12.e098330.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017359","article-title":"Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study","volume":"8","author":"Seo","year":"2018","journal-title":"BMJ Open"},{"key":"2026010703523853000_15.12.e098330.11","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.3390\/ijerph17072328","article-title":"A Cohort Study of Korean Radiation Workers: Baseline Characteristics of Participants","volume":"17","author":"Park","year":"2020","journal-title":"IJERPH"},{"key":"2026010703523853000_15.12.e098330.12","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt228"},{"key":"2026010703523853000_15.12.e098330.13","unstructured":"Occupational safety and health research institute. guidelines for occupational medical examinations (2020-oshri-349). 2020."},{"key":"2026010703523853000_15.12.e098330.14","doi-asserted-by":"publisher","DOI":"10.2307\/2529876"},{"key":"2026010703523853000_15.12.e098330.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2013.12.003"},{"key":"2026010703523853000_15.12.e098330.16","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.49.8.664"},{"key":"2026010703523853000_15.12.e098330.17","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.3324\/haematol.2022.282131","article-title":"How different are blood platelets from women or men, and young or elderly people?","volume":"108","author":"De Gaetano","year":"2023","journal-title":"Haematologica"},{"key":"2026010703523853000_15.12.e098330.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2005.06.052"},{"key":"2026010703523853000_15.12.e098330.19","unstructured":"ICRP . 37. The 2007 recommendations of the international commission on radiological protection. ICRP Publication. 1\u2013332."},{"key":"2026010703523853000_15.12.e098330.20","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/nyas.14096","article-title":"Variation in hemoglobin across the life cycle and between males and females","volume":"1450","author":"Jorgensen","year":"2019","journal-title":"Ann N Y Acad Sci"},{"key":"2026010703523853000_15.12.e098330.21","doi-asserted-by":"publisher","DOI":"10.1667\/RR3258"},{"key":"2026010703523853000_15.12.e098330.22","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105019"},{"key":"2026010703523853000_15.12.e098330.23","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010316","article-title":"Cancer and non-cancer mortality among French uranium cycle workers: the TRACY cohort","volume":"6","author":"Samson","year":"2016","journal-title":"BMJ Open"},{"key":"2026010703523853000_15.12.e098330.24","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-01875-2"},{"key":"2026010703523853000_15.12.e098330.25","first-page":"979","article-title":"Definition, sources, magnitude, effect modifiers, and strategies of reduction of the healthy worker effect","volume":"34","author":"Choi","year":"1992","journal-title":"J Occup Med"},{"key":"2026010703523853000_15.12.e098330.26","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1080\/19338244.2022.2089088","article-title":"Does occupational ionizing radiation exposure in healthcare workers affect their hematological parameters?","volume":"78","author":"G\u00fcng\u00f6rd\u00fc","year":"2023","journal-title":"Arch Environ Occup Health"},{"key":"2026010703523853000_15.12.e098330.27","doi-asserted-by":"crossref","first-page":"35757","DOI":"10.1007\/s11356-022-24652-8","article-title":"Exposure to ionizing radiations and changes in blood cells and interleukin-6 in radiation workers","volume":"30","author":"Bahrami Asl","year":"2023","journal-title":"Environ Sci Pollut Res Int"},{"key":"2026010703523853000_15.12.e098330.28","doi-asserted-by":"publisher","DOI":"10.1667\/RR3470.1"},{"key":"2026010703523853000_15.12.e098330.29","doi-asserted-by":"publisher","DOI":"10.1080\/09553000010024911"},{"key":"2026010703523853000_15.12.e098330.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.06.045"},{"key":"2026010703523853000_15.12.e098330.31","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1093\/jrr\/rrz059","article-title":"Inflammatory profile dysregulation in nuclear workers occupationally exposed to low-dose gamma radiation","volume":"60","author":"Aneva","year":"2019","journal-title":"J Radiat Res"},{"key":"2026010703523853000_15.12.e098330.32","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.118.312338"},{"key":"2026010703523853000_15.12.e098330.33","first-page":"632","article-title":"Korea Disease Control and Prevention Agency. Trends in the prevalence of current cigarette smoking (2012\u20132021)","volume":"16","year":"2023","journal-title":"Public Health Weekly Report"},{"key":"2026010703523853000_15.12.e098330.34","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.shaw.2021.07.012","article-title":"Reliability and Validity of a Nationwide Survey (the Korean Radiation Workers Study)","volume":"12","author":"Lee","year":"2021","journal-title":"Saf Health Work"},{"key":"2026010703523853000_15.12.e098330.35","first-page":"628","article-title":"The Efficacy of Periodic Complete Blood Count Tests in Evaluation of the Health Status of Radiation Workers in Iran: A Systematic Review","volume":"49","author":"Zare","year":"2020","journal-title":"Iran J Public Health"},{"key":"2026010703523853000_15.12.e098330.36","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2016-103775"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-098330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:54:33Z","timestamp":1767786873000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-098330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,25]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bmjopen-2024-098330"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-098330","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}