Tompa Anna, Magyar Balázs, Tóth Ferenc, Biró Anna, Fodor Zoltán, Jakab Mátyás, Major Jenô
Közegészségtani Intézet, Semmelweis Egyetem, Budapest, Hungary.
Magy Onkol. 2006;50(2):153-61. Epub 2006 Aug 4.
Statistical data indicate a chronic shortage of work-force due to overwork, ill health state and increased risk of chronic noninfectious diseases in Hungarian health care personnel, which needs investigations in order to decrease the risk. Nurses of oncology units, often exposed to carcinogens when preparing and handling cytostatic drugs, are especially at high risk. In the present publication we report a complex clinical, geno- and immunotoxicology risk assessment of altogether 500 nurses, performed during the last 10 years at various oncology units in Hungary. The obtained results indicate that the health status of nurses at oncology units is better than the Hungarian average, especially of hypertonia and type II diabetes. However, the prevalence of iron deficiency anemia and different thyroid gland diseases is significantly higher than those of the controls matched for sex and age. The results suggest that iron deficiency can potentiate the resistance to insulin, i.e. the persistence of iron deficiency may increase the serum glucose levels and thus the risk of diabetes. Among the studied geno- and immunotoxicology biomarkers, the frequency of chromosome aberrations, sister chromatid exchange and B lymphocytes was significantly increased compared to the matched controls. The obtained alterations demonstrate the occupational exposure of the nurses to cytostatic drugs, thus the introduction of more strict hygienic controls and compliance with the European Union chemical safety regulations is necessary.
统计数据表明，匈牙利医护人员因工作过度、健康状况不佳以及慢性非传染性疾病风险增加而长期劳动力短缺，这需要进行调查以降低风险。肿瘤科室的护士在配制和处理细胞毒性药物时经常接触致癌物，尤其面临高风险。在本出版物中，我们报告了过去10年在匈牙利各肿瘤科室对总共500名护士进行的综合临床、基因和免疫毒理学风险评估。所得结果表明，肿瘤科室护士的健康状况优于匈牙利平均水平，尤其是高血压和II型糖尿病方面。然而，缺铁性贫血和不同甲状腺疾病的患病率明显高于按性别和年龄匹配的对照组。结果表明，缺铁会增强对胰岛素的抵抗，即缺铁持续存在可能会提高血糖水平，从而增加患糖尿病的风险。在所研究的基因和免疫毒理学生物标志物中，与匹配的对照组相比，染色体畸变、姐妹染色单体交换和B淋巴细胞的频率显著增加。所获得的改变表明护士职业性接触细胞毒性药物，因此有必要引入更严格的卫生控制措施并遵守欧盟化学安全法规。
