Nurses with dermal exposure to antineoplastic drugs - Reproductive outcomes
Nurses with dermal exposure to antineoplastic drugs - Reproductive outcomes
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DOI：
10.1097/01.ede.0000246827.44093.c1
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发表时间：
2007-01-01
期刊：
影响因子：
5.4
通讯作者：
Heederik, Dick
中科院分区：
文献类型：
--
作者：
Fransman, Wouter;Roeleveld, Nel;Heederik, Dick
背景：护士和其他医院工作人员在日常活动中暴露于阿片类药物。以前的研究表明，在职业暴露水平的抗抑郁药可能是有毒的生殖，但这些研究是不一致的或conclusive.Methods：自我管理的问卷调查完成了4393暴露和nonexposed护士在1990年和1997年（79%的响应）。询问了有关妊娠结局、工作相关暴露和生活方式的问题。使用基于任务的皮肤暴露测量和自我报告的任务频率估计暴露于阿片类药物。使用生存分析对妊娠时间进行建模，使用多元logistic回归分析计算其他生殖结局的比值比（OR）和95%置信区间（CI）。结果：高暴露于抗抑郁药的护士比参考护士需要更长的时间怀孕（调整后的风险比= 0.8; CI = 0.6-0.9）。暴露于抗氧化药物与早产（In[暴露]每单位增加的OR = 1.08; CI = 1.00-1.17）和低出生体重（In [暴露]每单位增加的OR = 1.11; 1.01-1.21）相关。惩罚平滑样条曲线证实了这些对数线性关系。自然流产，死产，先天性畸形，和后代的性别似乎不相关的暴露于抗肿瘤药物。结论：抗肿瘤药物可能会降低生育能力，并增加职业暴露的肿瘤科护士之间的新生儿预后不良。
Background: Nurses and other hospital workers are exposed to antineoplastic drugs during daily activities. Previous studies suggest that antineoplastic drugs at occupational exposure levels may be toxic to reproduction, but these studies are not consistent or conclusive.Methods: Self-administered questionnaires were completed by 4393 exposed and nonexposed nurses employed between 1990 and 1997 (79% response). Questions were asked about pregnancy outcome, work-related exposures, and lifestyle. Exposure to antineoplastic drugs was estimated using task-based dermal exposure measurements and self-reported task frequencies. Time to pregnancy was modeled using survival analysis, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for other reproductive outcomes using multiple logistic regression analysis. Associations were further explored by nonparametric regression modeling.Results: Nurses highly exposed to antineoplastic drugs took longer to conceive than referent nurses (adjusted hazard ratio = 0.8; Cl = 0.6-0.9). Exposure to antineoplastic drugs was associated with premature delivery (OR per unit increase in In[exposure] = 1.08; Cl = 1.00-1.17) and low birth weight (OR per unit increase in In [exposure] = 1.11; 1.01-1.21). Penalized smoothed spline plots corroborated these log-linear relations. Spontaneous abortion, stillbirth, congenital anomalies, and sex of offspring appeared not to be related to exposure to antineoplastic drugs.Conclusion: Antineoplastic drugs may reduce fertility and increase poor neonatal outcomes among occupationally exposed oncology nurses.