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EVALUATION OF THE SERUM TOTAL ANTIOXIDANT STATUS LEVEL IN HEALTH WORKERS EXPOSED TO LOW RADIATION DOSES IN A LARGE NIGERIAN HOSPITAL

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International Journal of Research and Reviews in Applied Sciences

ISSN: 2076-734X, EISSN: 2076-7366 Volume 1, Issue 2(November 2009)

_________________________________________________________________________________________

152

EVALUATION OF THE SERUM TOTAL ANTIOXIDANT

STATUS LEVEL IN HEALTH WORKERS EXPOSED TO

LOW RADIATION DOSES IN A LARGE NIGERIAN

HOSPITAL

OLISEKODIAKA MJ1, BELLO TO 2,ONUEGBU AJ1,OLOWOOKERE CJ3, LEBI OM1, OMOTAYO LO1, IGBENEGHU I1, OLUGBENGA- BELLO AI4

1Department of Biomedical Sciences, 2Radiology & 4Community Medicine Ladoke Akintola University of TechnologyCollege of Health Sciences

PMB 4400 Osogbo- Osun State, Nigeria 3Department of Physical Sciences

Ajayi Crowther University,Oyo,NigeriaOyo State, Nigeria.

ABSTRACT

Free radicals especially the reactive oxygen species (ROS) have been implicated in the etiology of over hundred diseases. Antioxidants terminate the detrimental effect of free radicals by interacting with them. Radiation is one of the major exogenous sources of free radicals in man and it has been proved that ionizing radiation produces ROS in biological system capable of destroying biomolecules, namely DNA, lipid, proteins and carbohydrate

The objective of this study is to measure the serum total antioxidant status (TAS) level in health workers in the Department of Radiology of a tertiary institution in Nigeria.

A case controlled study of 49 subjects made up of 23 subjects working with X-ray machines and 26 unexposed individuals.

The result shows that the mean serum TAS in exposed subjects (1.96mmol/L± 0.98) did not differ significantly when compared with that of the corresponding control group (2.42mmol/L±0.70).The serum TAS in workers exposed to chronic low radiation dose from x-ray machines and controls show no significant difference.

Key words: Total antioxidant status, radiation protection, free radicals.

INTRODUCTION:

Electromagnetic radiation comprises visible light and radio waves as well as high energy rays such as X- and Gamma- rays. High energy rays exert their effects by transferring energy to atoms and molecules that they encounter through excitation and ionization. These interactions lead to the production of free radicals and eventually may result in the oxidation or peroxidation of critical bio- molecules and oxidative stress which play critical roles in the pathogenesis of many chronic diseases1. Man has lived with natural radiation since the beginning of time, but in recent years there has been an increase in artificial radiation, predominantly from medical uses.

All ionizing radiation is harmful; this is the basis for radiation protection. In biologic systems, nature however handles the challenges posed by free radicals through an integrated control of the body’s antioxidant systems. The antioxidant system consist of enzyme and non enzyme antioxidants. Antioxidants prevent free radical induced tissue damage by preventing the formation of radicals, scavenging them, or by promoting their decomposition2.

It has been postulated that ionizing radiation generates reactive oxygen species (ROS)2.Workers

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antioxidant status. In this group, some studies have demonstrated significantly reduced serum total antioxidant status when compared with controls and associated genetic injuries3, 4.

The aim of our study was to evaluate influence of low doses of ionizing radiation on serum antioxidant status in workers operating X-ray machinery.

MATERIALS AND METHODS:

A total of forty nine subjects (aged 20-50 years) consisting of 23 test subjects (16 males and 7 females) and 26 (14 males and 12 females) controls were recruited for the study. The test subjects are the health workers in the Radiology department of our institution, this workers were monitored by radiation dosimeters provided by Radiation Safety Technology, Lagos, Nigeria. The control subjects were made up of patients that came for routine medical checkup and had been confirmed as apparently healthy by physical examination. Informed consent was obtained, following a through explanation of the aims and objectives of the study to the subjects. Ethical approval was obtained from the ethical committee of the hospital.

Subjects continued with their habitual diets during the period of the study but those taking any form of vitamins or mineral supplements and antibiotics were excluded from the study. Control subjects who had been recently exposed to medical or diagnostic radiation were also excluded from the study.

The peripheral venous blood samples of the subjects were collected into sterile collection tube with lithium heparin as anticoagulant and centrifuge at 3,500 rpm for 15minutes. The supernatants were taking into a plain tube and stored at 200C until analyzed for total antioxidant status (TAS) within 36 hours of collection. Total antioxidant activity (TAS) was estimated using the Thiobarbituric Acid Reactive Substances (TBARS) method described by Koracevic et al.5

, the values in this study were expressed as mean ± standard deviation. SPSS for windows, standard version 12.0 was used for statistical analysis. RESULTS:

Forty nine individuals were involved in the study, comprising 23 test subjects and 26 controls. Table 1 show that the mean age of the test subject was 34.83+5.25 and that of the control is 32.2+9.15 (p value greater than 0.05), also, that the mean total antioxidant status (TAS) in test group is (1.96mmol/L ± 0.98) did not differ significantly (P>0.05) when compared to the corresponding controls (2.42mmol/L±0.70).

Table 2 shows within the group variation of TAS cross tabulated by gender, higher TAS level was noted in males (2.06mmol/L±1.06) as compared to the females in the test group, but in the control group females had higher levels of TAS (2.50mmol/L±0.79) when compared to males (2.36mmol/L± 0.63) however, these differences were not of statistical significance

DISCUSSION:

Ionizing radiation generates the production of reactive oxygen species (ROS) such as superoxide, hydrogen peroxide and hydroxyl radical in a variety of cells6 . ROS manifest high reactivity to cellular

macromolecule components including DNA, lipids and proteins. In the healthy individual, there is a balance between free radical formation and anti-oxidant capacity. However, when this balance is disrupted by a disease process or as a result of excess exposure to ionizing radiation it can lead to oxidative stress7,8 ,9. Oxidative stress is thought to play an important role in several neuropsychiatric diseases including obsessive–compulsive disorder (OCD), in critically ill patients and in the pathogenesis of cardiovascular diseases7,8,2.

This study showed that mean total antioxidant status (TAS) in the test subjects (1.96mmol/L) was lower than that of the control subjects ( 2.42mmol/L), but the difference in means was not statistically significant. In contrast to this study, a similar study in Japan showed that radiation workers have significantly lower antioxidant levels than controls8. The difference may be due to greater use of fluoroscopy for interventional radiological procedures in the developed world, fluoroscopy imparts a very

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large portion of the radiation dose delivered in diagnostic medical imaging because of continuous x-ray production and real time image output. Interventional radiology is presently poorly developed in Nigeria and forms an insignificant part of radiological procedures in the country. A similar study in which intracellular erythrocyte antioxidant enzymes were estimated, showed that radiation workers have significant lower intracellular enzyme values , but the serum antioxidant assay was not significantly different between controls and test subjects, similar to the findings of this study3.

It has been observed that the accurate assessment of oxidative stress in biological systems is a problem for all investigators working on the role of free radical damage in disease. The best method for a comprehensive assessment of oxidative stress in biological systems would include the measurement of all of antioxidants, and this would be time consuming, expensive, and in some cases technically difficult10,11,12, 13.

In conclusion, this pilot study showed that serum TAS, was not significantly different in health workers in the radiology department and unexposed controls. However, the recent introduction of multi-slice Serial Computerized Tomography Scanners and Digital Fluoroscopy units in the country will result in increase of radiation dose to health workers in the radiology department; we suggest that research on radiation protection and hazards should be encouraged to prevent irreversible genetic injury in the future.

Table 1:- showing the demographic characteristics of the study groups and the serum TAS levels

Test Subjects (n=23) Control Subjects (n=26) p value Age 34.85± 5.25 32.19± 9.12 >0.05 Sex Males 16(69.56%) 14 (53.84%) Females 7 (30.43%) 12 (46.15%) Serum TAS(mmol/L) 1.96±0.98 2.42±0.70 >0.05

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Table 2 Means and (±SD) and t- test of serum TAS in test and control groups cross tabulated by gender.

REFERENCES:

1.

Halliwell B, Gutteridge JC. The definition and measurement of antioxidants in

biological systems. Free Radic Biol Med 1995;18:125–6.

2.

Cohen B.L. Cancer risk from low-level radiation. Am J Roentgenol 2002;

179:1137-1143.

3.

K

ł

uci

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ski P, Wójcik A,Grabowska-Bochenek R, Gmi

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Cie

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lik P, Martirosian G. Erythrocyte antioxidant parameters in workers

occupationally exposed to low levels of ionizing radiation. Ann Agric Environ

2008; 15: 9–12

4.

Boyaci B, Yalcin R, Cengel A, Erdem O, Dortlemez O, Dortlemez H, Sardas S:

Evaluation of DNA damage in lymphocytes of cardiologists exposed to radiation

during cardiac catheterization by the COMET ASSAY.

Jpn Heart J

2004; 45:

845-853

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Koracevic D, Koracevic G, Djordjevic V, et al. Method for the measurement of

antioxidant activity in human fluids. J Clin Pathol 2001;54:356–61.

6.

Atta M, Molaie Y,Khansari N.Effect of High Dose Natural Ionizing Radiation on

the Immune System of the Exposed Residents of Ramsar Town, Iran. Iran J

Allergy Asthma Immunol 2007; 6: 73-78

Sex N TAS(mmol/L) P-value

Test Male 16 2.06±1.06 >0.05

Female 7 1.71±0.76

Control Male 14 2.36±0.63 >0.05

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7.

Chakraborty S,

Singh OP, Dasgupta A, MandalN, Nath Das H. Correlation

between lipid peroxidation-induced TBARS level and disease severity in

obsessive–compulsive disorder. Progress in Neuro-Psychopharmacology and

Biological Psychiatry 2009; 33: 363-366.

8.

Hagelstrom AH, Gorla NB, Larripa IB: Chromosomal damage in workers

occupationally exposed to chronic low level ionizing radiation. Toxicol Lett

1995;76:113-117.

9.

De Zwart LL, Meerman JN, Commandeur JM, et al. Biomarkers of free radical

damage applications in experimental animals and in humans. Free Radic Biol

Med 1999;26:202–26.

10. Young I. S. Measurement of total antioxidant capacity. J. Clin. Pathol. 2001;

339:10.11

11. Marklund S. Human copper-containing superoxide dismutase of high molecular

weight. Proc Natl Acad Sci USA 1982;79:7634–8.

12. Bond V.P., Benary V., Sondhaus C.A. . A different perception of the linear,

non-threshold hypothesis for low-dose irradiation. Proc. Natl. Acad. Sci. USA 1991;

88: 8666-8670.

13. Rosenfeld ME. Inflammation, lipids, and free radicals: lessons learned from the

atherogenic process. Semin Reprod Endocrinol 1998;16:249–61.

References

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