A pooled analysis to study trends in exposure to antineoplastic drugs among nurses
A pooled analysis to study trends in exposure to antineoplastic drugs among nurses
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DOI：
10.1093/annhyg/mel081
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发表时间：
2007-04-01
影响因子：
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通讯作者：
Kromhout, Hans
中科院分区：
文献类型：
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作者：
Fransman, Wouter;Peelen, Susan;Kromhout, Hans
目的：一些研究表明，接触抗肿瘤药物可对生殖健康造成毒性影响以及致癌作用。许多研究证实，医院工作人员接触这些药物。本研究的重点是在暴露于抗肿瘤药物的趋势，因为在荷兰的指南介绍。方法：从三个横断面暴露调查在荷兰进行的数据汇总，以研究职业暴露于环磷酰胺的趋势。护士的24小时尿液样本进行了分析，在单独的部分，表面污染进行了测定，并在制备过程中使用的手套或同时处理患者尿液收集。通过广义估计方程（GEE）二项式回归模型确定1997年和2000年之间可检测尿液样本的差异。混合模型被用来研究表面和手套的污染levels.Results的时间趋势：护士的尿液样本与检测环磷酰胺的百分比下降了4倍，1997年和2000年之间。2000年阳性尿样中的环磷酰胺水平中位数比1997年低3倍。从1997年到最近几年，表面和手套污染在统计上显著减少。在门诊诊所或肿瘤病房工作的护士仍然暴露于环磷酰胺，但在1997年至2000年期间，他们的暴露量大幅下降，这可能是由于荷兰引入了详细的指南和法规，随后LuerLock连接和预充盐水的输注系统的使用增加，以及护士对使用麻醉药物的危害意识不断提高。
Objectives: Several studies have shown that exposure to antineoplastic drugs can cause toxic effects on reproductive health as well as carcinogenic effects. Numerous studies have corroborated that hospital workers are exposed to these drugs. This study focused on trends in exposure to antineoplastic drugs since the introduction of guidelines in The Netherlands.Methods: Data from three cross-sectional exposure surveys conducted in The Netherlands were pooled to examine trends in occupational exposure to cyclophosphamide. Nurses' 24 h urine samples were analyzed in separate fractions, surface contamination was determined and gloves used during preparation or while handling patient urine were collected. The difference in detectable urine samples between 1997 and 2000 was determined by a generalized estimating equations (GEE) binomial regression model. Mixed models were used to study the time trend in surface and glove contamination levels.Results: The percentage of nurses' urine samples with detectable cyclophosphamide had decreased 4-fold between 1997 and 2000. Median cyclophosphamide levels in the positive urine samples were 3-fold lower in 2000 than in 1997. Surface and glove contamination had statistically significantly decreased between 1997 and more recent years.Conclusions: Nurses working at outpatient clinics or oncology wards are still being exposed to cyclophosphamide, but their exposure decreased considerably between 1997 and 2000, presumably due to the introduction of detailed guidelines and regulations in The Netherlands, the subsequent increased use of LuerLock connections and infusion systems prefilled with saline, and growing hazard awareness of nurses working with antineoplastic drugs.