الفهرس 
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Abstract
One of the most important occupational exposures is IR. Most of adverse effects of low dose of IR are due to Oxidative stress (OS). OS can be incorporated in many diseases. Diet compo sition can influence oxidative damage power and antioxidant mechanism. Healthy nutrition and dietary supplement (DS) (which include antioxidants and micronutrients) may overcome the effect of low dose of IR and decrease oxidative stress so prevent many diseases among HCWs exposed to IR.
This study assesses oxidative stress status of health care workers (HCWs) exposed to low dose of IR and describe dietary diversity and nutritional status by nutritional screening of HCWs and their accessibility to nutritious, safe, affordable food and compare oxidative stress status of exposed HCWs who receive prescribed DS with those who do not as a step to implement national strategy of healthy nutrition for HCWs and to prevent hazards of occupational exposure to IR.
The current study was a comparative cross-sectional study. HCWs were recruited from Ain Shams University hospitals and divided into 3 groups matched for age and sex (25 exposed to IR and not taking DS (group1), 25 exposed to IR and on DS (group2) and 25 neither exposed to IR nor on DS (group 3). Most of group 1 (IR exposed group without DS) were recruited from cardiac catheterization, collective operating theatre which include (orthopedics, neurosurgery, vascular and urology). Most of the group 2 (IR exposed group and on DS) were recruited from radiodiagnosis (conventional and interventional) departments, and isotopic scan where provided with DS and have regular periodic medical examination. While unexposed group was recruited from wards of vascular, urology, orthopedics and neurosurgery departments. All HCWs in the three groups were chosen by simple random sampling techniques.
Data were collected using an interview questionnaire from all HCWs included in the study including personal history, occupational history, health status, symptoms of low immunity, health complaints, OS questionnaire and Food Frequency Questionnaire (FFQ) in addition to quality and their accessibility to food. Clinical examination and investigation by plasma MDA level measurements and CBC were done for all groups. Moreover, recording readings of available radiation exposure level (personal and at workplaces) were done.
Results of the study showed that group1 was significant higher in OS status (which measured by plasma MDA level) than group2 and group 3. While there was no statistically significant difference between group 2 (exposed on DS) and group 3 (unexposed group).
Results also showed that nutritional habits as eating breakfast regularly, eating fruits and vegetables between meals were significantly higher among group 2 and 3 than group 1. Moreover nutritional sources of antioxidants as weekly times of cooked, fresh vegetables, fruits, milk, milk products in addition to beans, eggs, ground seasm, green tea were significantly higher among (group 2 and 3) than group 1, (except egg were significant higher in un exposed group than both exposed groups). Consuming of natural butter (saturated fat) was significantly more frequent among (group 2 and 3) than group 1 while PUFA consumption was significantly higher among exposed groups (group 1 and 2) than unexposed. Results showed that unhealthy nutrition as highly processed food and trans-fats were significantly more consumed among exposed groups (especially exposed group without DS) than unexposed group.
Results of multiple linear regression analysis showed that exposure to IR without intake of DS can independently aggravate oxidative stress status by increasing MDA level. Also consuming of healthy dietary pattern as plenty of fresh fruits can significantly reduce total score of OS. On the contrary adherence to the unhealthy pattern, characterized by higher intakes of processed foods, significantly aggravates total score of OS. Also, TFA has positive association with total score of OS, while SF has negative association with it but with no significant value. So healthy nutrition (fresh fruits) with dietary supplement (which contains antioxidant e.g: vitamins and micronutrients can overcome OS status and the effect of low dose of IR and so preventing more diseases due that OS status. On the other hand, exposure to IR plus unhealthy nutrition can be incorporated to increase oxidative stress status.
As regards facilities available for nutrition, most of exposed with DS were provided by meals from work. Most of those provided by meals from work showed that those meals were of unsuitable quality and were not enough and that they need to buy food during shift. They stated that lunch contains all essential elements but not breakfast. Most of HCWs eat from outside hospital restaurant because they were not provided by meals from work or due to small amount of work meal.
As regards health complaints and general health status the results showed that chronic exposure to low doses of ionizing radiation (IR) cause many health complaints as hair fall, musculoskeletal pain, upper abdominal pain, constipation, decreased visual acuity and being easily agitated in comparison to unexposed group. chronic exposure to low doses of IR affects general health status and immune system, significant clinical symptoms related to immunity troubles as (repeated infections, common cold and GIT disturbances) have been reported in exposed groups. As regards CBC, results showed that significant changes of some basic blood parameters as platelets, absolute, relative basophils, eosinophils, MCH and hematocrit among IR exposed workers were significantly different between groups (although all hematological parameters were within normal range).