Influence of occupational exposure to antineoplastic agents on adverse pregnancy outcomes among nurses: A meta-analysis

Pregnant nurses' occupational stress and associated factors: A comparative cross-sectional study with other healthcare workers, physical workers, and desk workers

AIM

To examine occupational stress levels and associated factors among pregnant nurses through a comparison with pregnant non-nurses.

METHODS

This cross-sectional study included 1060 working pregnant women. Participants completed questionnaires including the Brief Job Stress Questionnaire, work conditions, obstetric conditions, Sense of Coherence Scale, and self-management behaviors questionnaire. The participants were categorized into four groups: nurses, other healthcare workers, physical workers, and desk workers. Comparisons were made between the four groups and by gestational ages using Dunnett's test and chi-squared test, and associated factors were examined using ordinal logistic regression analysis.

RESULTS

Analysis of 847 valid responses showed that the nurse group had a higher occupational stress, higher job demand, and lower job control at any gestational age than the other profession groups. Nurses' occupational stress was associated with factors such as frequent overtime work, fewer break times, lower manager support, and lower prioritizing the fetus. Particularly, fewer break times and lower prioritizing the fetus were nurse-specific associated factors.

CONCLUSIONS

The study showed that pregnant nurses are exposed to higher occupational stress throughout the entire pregnancy than other occupations. The stress was related to modifiable factors such as fewer break times and lower prioritizing the fetus. To manage occupational stress, pregnant nurses should avoid overtime, take breaks, and prioritize the fetus in the workplace. Hospital administrators would need to provide work coordination support and consider certain regulations regarding hazardous work restrictions for pregnant nurses. Future cohort studies are required to better understand occupational stress among pregnant nurses.

Application of a multifunctional chemotherapy infusion device for reducing antineoplastic drug extravasation

Objective

This study aimed to address the challenges associated with antineoplastic drug extravasation during intravenous administration, through the development of a novel chemotherapy infusion device. A secondary objective was to mitigate associated risks to healthcare personnel, patients, caregivers and the environment.

Methods

A water-soluble fluorescent solution was used as a surrogate for antineoplastic chemotherapy agents to assess the potential for drug extravasation and the associated risks of occupational exposure during intravenous administration. The investigation identified risks related to drug extravasation, which informed the development of the novel infusion device.

Results

In experiment 1, conventional methods for replacing infusion bags resulted in drug extravasation during the second bag change across all procedures conducted by 9 operators. Specifically, extravasation was observed in 81 out of 90 procedures. In experiment 2, the newly designed multifunctional chemotherapy infusion device, which requires each infusion bag to be punctured only once, was used. Under these conditions, the same 9 operators performed 90 procedures, with extravasation occurring in only 2 instances.

Conclusion

The multifunctional chemotherapy infusion device facilitates the efficient administration of intravenous chemotherapy while addressing the issue of drug extravasation associated with traditional infusion devices during the delivery of antineoplastic drugs. This device effectively reduces the risk of occupational injuries among healthcare workers, reduces harm to patients and their caregivers, and mitigates environmental contamination.

Parental occupational exposure to anticancer drugs and radiation: Risk of fetal loss and physical abnormalities in The Japan Environment and Children's Study

BACKGROUND

Many studies have indicated an association between maternal occupational exposure to hazardous agents, such as anticancer drugs and ionizing radiation, and an increased risk of adverse pregnancy outcomes, including stillbirths or miscarriages and physical abnormalities in offspring. However, the effects of recent advancements in protective measures to reduce these risks have not been clarified. Aim To investigate the current impact of parental occupational exposure to anticancer drugs and ionizing radiation on stillbirths or miscarriages as well as physical abnormalities under the circumstances of the developed safety protocols.

METHODS

This cohort study utilized The Japan Environment and Children's Study dataset, which included 96,606 fetuses born between January 2011 and March 2014. This study focused on the association between occupational exposure to these agents during pregnancy and the incidence of stillbirths or miscarriages and physical abnormalities in offspring, employing Poisson regression models for adjusted relative risk.

RESULTS

From the study population, 471 cases of stillbirths or miscarriages and 4493 infants with physical abnormalities were identified. Fisher's exact tests indicated no significant differences in fetal loss or physical abnormalities between the exposure groups. A multivariable analysis also found no significant association between maternal exposure to anticancer drugs and ionizing radiation and these adverse outcomes.

CONCLUSION

Under improved safety measures, maternal occupational exposure to anticancer drugs and ionizing radiation does not significantly affect the occurrence of stillbirths or miscarriages and physical abnormalities in offspring. These findings highlight the critical role of current safety practices and indicate lower reproductive risks with proper precautions.

Evaluating oxidative stress biomarkers in oncology nurses exposed to antineoplastic drugs: A cross-sectional study

PURPOSE

Antineoplastic drugs (ADs) are widely used in cancer treatment. Nurses in chemotherapy centers are exposed to these drugs during preparation. They can affect healthy cells, leading to teratogenic and mutagenic effects, as well as oxidative stress. This study aimed to evaluate oxidative stress biomarkers in the nurses exposed to these drugs.

METHOD

This study was conducted on 30 nurses exposed to ADs and 30 nurses with no exposure to these drugs as non-exposed group. Oxidative stress biomarkers were measured in the blood serum samples of both groups, including malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), total antioxidant capacity (TAC), and blood thiol groups.

RESULTS

Considering the possibility of confounding effect of nutritional supplement consumption, the effect of this factor was adjusted in the analysis. A significant difference was observed for CAT, SOD, thiol, and TAC biomarkers between two groups (P < 0.05). However, the difference in MDA and GPx biomarkers between two groups was not statistically significant.

CONCLUSIONS

The findings of the present study showed that supplement consumption has a significant effect on the biomarker of total antioxidant capacity. Thus, total antioxidant capacity measurement is advised as the best biomarker for tracking oxidative status in nurses exposed to ADs due to its capacity to measure all antioxidants in the body, except the thiol group, and its lower cost when compared to other biomarkers. Furthermore, it can be claimed that the consumption of nutritional supplements has a greater effect on the non-enzymatic biomarkers of oxidative stress than on enzymatic antioxidant system.

Pediatric leukemia and maternal occupational exposure to anticancer drugs: the Japan Environment and Children's Study

ABSTRACT

Occupational exposure to medical agents and ionizing radiation has been suggested as a possible risk factor for childhood cancer. However, the relationship between such exposure and pediatric malignant neoplasms has not yet been comprehensively studied. This cohort study aimed to investigate the association between parental occupational exposure to hazardous medical agents or ionizing radiation and the risk of childhood cancer in offspring. Data from a large birth cohort in Japan, which included 104 062 fetuses, were analyzed. The primary outcome was the development of leukemia or brain tumors diagnosed by community physicians during the first 3 years after birth. Exposure factors were medical agents, including anticancer agents, ionizing radiation, and anesthetics, handled by mothers during pregnancy or by fathers for 3 months before conception. The incidence of leukemia, but not of brain tumors, was higher in mothers exposed to anticancer drugs. Multivariable regression analysis showed that maternal exposure to anticancer drugs was associated with an increased risk of leukemia in offspring older than 1 year (adjusted relative risk, 7.99 [95% confidence interval, 1.98-32.3]). Detailed information obtained from medical certificates of patients with identified leukemia revealed no infant leukemia but acute lymphoblastic leukemias in the exposed group. Our findings suggest that maternal occupational exposure to anticancer drugs may be a potential risk factor for acute lymphoblastic leukemia in offspring older than 1 year. Effective prevention methods may be necessary to prevent maternal exposure to anticancer drugs and to reduce the risk of childhood malignant neoplasms.