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Occupational exposures among nurses and risk of spontaneous abortion

Identifier

027602

Type of Spiritual Experience

None

Background

What are antineoplastic drugs?
Antineoplastic drugs are medications used to treat cancer. Antineoplastic drugs are also called anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs.
These drugs come in many forms. Some are liquids that are injected into the patient and some are pills that patients take.

A description of the experience

Am J Obstet Gynecol. Author manuscript; available in PMC 2015 Sep 16.
 
Published in final edited form as:
Am J Obstet Gynecol. 2012 Apr; 206(4): 327.e1–327.e8.
Published online 2011 Dec 30. doi:  [10.1016/j.ajog.2011.12.030]
PMCID: PMC4572732
NIHMSID: NIHMS524347
PMID: 22304790
Occupational exposures among nurses and risk of spontaneous abortion
Christina C LAWSON, Ph.D.,1 Carissa M. ROCHELEAU, Ph.D.,1 Elizabeth A WHELAN, Ph.D.,1 Eileen N. LIVIDOTI HIBERT, M.A.,2 Barbara GRAJEWSKI, Ph.D.,1 Donna SPIEGELMAN, Sc.D.,3,4 and Janet W. RICH-EDWARDS, Sc.D.3,5


Objective
We investigated self-reported occupational exposure to antineoplastic drugs, anesthetic gases, antiviral drugs, sterilizing agents (disinfectants), and X-rays and the risk of spontaneous abortion in U.S. nurses.
Study Design
Pregnancy outcome and occupational exposures were collected retrospectively from 8,461 participants of the Nurses’ Health Study II. Of these, 7,482 were eligible for analysis using logistic regression.
Results
Participants reported 6,707 live births, and 775 (10%) spontaneous abortions (<20 weeks). After adjusting for age, parity, shift work, and hours worked, antineoplastic drug exposure was associated with a 2-fold increased risk of spontaneous abortion, particularly with early spontaneous abortion before the 12th week, and 3.5-fold increased risk among nulliparous women. Exposure to sterilizing agents was associated with a 2-fold increased risk of late spontaneous abortion (12–20 weeks), but not with early spontaneous abortion.
Conclusion
This study suggests that certain occupational exposures common to nurses are related to risks of spontaneous abortion.
Keywords: antineoplastic agents, health personnel, occupational exposure, pregnancy


INTRODUCTION
Over two million women are employed as nurses,1 representing 4% of all employed women in the US.2 Nurses are potentially exposed to several suspected reproductive hazards, including anesthetic gases, antineoplastic (chemotherapy) drugs, antiviral drugs, sterilizing agents (disinfectants), and X-rays (ionizing radiation).3–9 Though the nursing profession is a critical component of the health care system, the effect of commonly encountered occupational exposures on reproductive health remains unclear within this predominantly female occupation.

Many previous studies of nursing exposures and spontaneous abortion lack adequate numbers of exposed cases to allow adjustment for confounders. Even though awareness of hazardous drug exposure has increased, protocols to reduce exposure of health care personnel to these chemicals have been insufficient to eliminate the exposure.10, 11 To clarify previous study results, we investigated the association between reported occupational exposures and risk of spontaneous abortion among participants of the Nurses’ Health Study II.

The source of the experience

PubMed

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Commonsteps

References