Beyond radiation dosimetry: metabolic burden and a possible healthy worker survivor pattern in the medical imaging...

Current occupational health protocols in radiology remain strongly focused on ionizing radiation while underemphasizing metabolic health concerns potentially associated with sedentary and shift-based occupational environments. This study examined the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in medical imaging professionals and evaluated whether the observed tenure-related pattern was more consistent with early-career occupational burden and possible survivor-selection processes than with a simple linear cumulative-risk model.

A cross-sectional analysis was conducted among 235 medical imaging professionals. NAFLD was diagnosed by abdominal ultrasonography according to APASL-based criteria. Restricted Cubic Spline (RCS) regression and multivariable logistic models were used to evaluate tenure-related patterns and metabolic predictors. Supplementary analyses further assessed waist circumference, work-schedule characteristics, multicollinearity using variance inflation factors (VIFs), and model robustness across alternative specifications.

The cohort exhibited a NAFLD prevalence of 47.7%. Occupational tenure showed a non-linear pattern, with prevalence rates of 44.1%, 61.9%, 32.5%, and 52.3% across the <5 years, 5-10 years, 10-20 years, and >20 years groups, respectively. Participants with NAFLD had a larger waist circumference than those without NAFLD (112.7 ± 5.1 cm vs. 105.6 ± 6.5 cm). Across sensitivity analyses, BMI remained the most stable metabolic predictor (OR 1.45-1.49), whereas the tenure-related effect was less stable. These findings are compatible with a possible survivor-selection pattern but require cautious interpretation.

These findings do not support a simple linear interpretation of tenure-related metabolic risk. Instead, they suggest that adiposity-related metabolic burden is more robustly associated with NAFLD than occupational tenure alone, and that the observed tenure pattern may be compatible with survivor-selection processes. Future studies should directly quantify shift-related, circadian, and behavioral exposures, and metabolic surveillance may usefully complement existing dosimetry-centered occupational monitoring.