Blood oxidative stress parameters in hospital workers occupationally exposed to low doses of ionizing radiation: A systematic review and meta-analysis

Abstract

This study conducted a systematic review and meta-analysis to explore the relationship between blood oxidative stress biomarkers and exposure to low-dose ionizing radiation in medical radiation workers. The researchers searched PubMed, Scopus, Web of Science, and Google Scholar for relevant studies until February 2023. They assessed the quality of the studies using the Newcastle‒Ottawa Scale (NOS) and used a random-effects model to combine the results. The I-square test was employed to assess study heterogeneity. The effect sizes were represented by standardized mean differences (proxied by Hedges' g) with a 95 % confidence interval. Out of 295 initial articles, 38 studies met the inclusion criteria for the meta-analysis. The systematic review results revealed a significant difference in blood oxidative stress biomarkers with exposure to low-dose ionizing radiation in medical radiation workers. Furthermore, the overall effect size of MDA was notably higher than that of the control group (p < 0.05). However, the effect size did not show any significant difference between the two groups for other parameters (SMDs ranged from [-0.92, 2.10] for 8-OHdG, [-3.47, 4.48] for reduced glutathione, [-1.08, 3.61] for CAT, [-5.03, 18.35] for SOD, [-2.52, 2.56] for TAC (p > 0.05)).

Keywords: Antioxidants; Health workers; Occupations; Oxidation-reduction; Radiation.

Fig. 1

PRISMA flowchart with the main steps of the research.

Fig. 2

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting the 8OHDG. The p value was calculated using the Cochrane Q test for heterogeneity.

Fig. 3

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting reduced glutathione. The p value was calculated using the Cochrane Q test for heterogeneity.

Fig. 4

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting the CAT. The p value was calculated using the Cochrane Q test for heterogeneity.

Fig. 5

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting the MDA. The p value was calculated using the Cochrane Q test for heterogeneity.

Fig. 6

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting the SOD. The p value was calculated using the Cochrane Q test for heterogeneity.

Fig. 7

The forest plot of Hedges' g (vertical markers) with its precision (gray square) and 95 % confidence interval (horizontal line) of primary studies reporting the TAC. The p value was calculated using the Cochrane Q test for heterogeneity.