Christina C. Lawson is the epidemiology team leader, Candice Y. Johnson and Carissa M. Rocheleau are epidemiologists, and James M. Boiano is an industrial hygienist in the Division of Surveillance, Hazard Evaluations, and Field Studies at the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati, OH. Feiby L. Nassan is a postdoctoral research fellow at the Harvard T. H. Chan School of Public Health in Boston. Thomas H. Connor is a research biologist in the Division of Applied Research and Technology at NIOSH. Jorge E. Chavarro is an associate professor in the Departments of Nutrition and Epidemiology at the Harvard T.H. Chan School of Public Health at Harvard Medical School, as well as the principal investigator of the Nurses' Health Study 3. Janet W. Rich-Edwards is the director of developmental epidemiology at the Mary Horrigan Connors Center for Women's Health and Gender Biology at Brigham and Women's Hospital and Harvard Medical School. Rich-Edwards received grant funding from NIOSH to support data analysis (grant no. 200-2013-M-54978). Contact author: Christina C. Lawson,
Am J Nurs. 2019 Jan;119(1):28-35. doi: 10.1097/01.NAJ.0000552583.69729.51.
: Background: Many antineoplastic (chemotherapeutic) drugs are known or probable human carcinogens, and many have been shown to be reproductive toxicants in cancer patients. Evidence from occupational exposure studies suggests that health care workers who have long-term, low-level occupational exposure to antineoplastic drugs have an increased risk of adverse reproductive outcomes. It's recommended that, at minimum, nurses who handle or administer such drugs should wear double gloves and a nonabsorbent gown to protect themselves. But it's unclear to what extent nurses do.
This study assessed glove and gown use by female pregnant and nonpregnant nurses who administer antineoplastic drugs in the United States and Canada.
We used data collected from more than 40,000 nurses participating in the Nurses' Health Study 3. The use of gloves and gowns and administration of antineoplastic drugs within the past month (among nonpregnant nurses) or within the first 20 weeks of pregnancy (among pregnant nurses) were self-reported via questionnaire.
Administration of antineoplastic drugs at any time during their career was reported by 36% of nonpregnant nurses, including 27% who reported administering these drugs within the past month. Seven percent of pregnant nurses reported administering antineoplastic drugs during the first 20 weeks of pregnancy. Twelve percent of nonpregnant nurses and 9% of pregnant nurses indicated that they never wore gloves when administering antineoplastic drugs, and 42% of nonpregnant nurses and 38% of pregnant nurses reported never using a gown. The percentage of nonpregnant nurses who reported not wearing gloves varied by type of administration: 32% of those who administered antineoplastic drugs only as crushed pills never wore gloves, compared with 5% of those who administered such drugs only via infusion.
Despite longstanding recommendations for the safe handling of antineoplastic and other hazardous drugs, many nurses-including those who are pregnant-reported not wearing protective gloves and gowns, which are considered the minimum protective equipment when administering such drugs. These findings underscore the need for further education and training to ensure that both employers and nurses understand the risks involved and know which precautionary measures will minimize such exposures.
本研究评估了在美国和加拿大，接触和管理抗肿瘤药物的孕妇和非孕妇护士使用手套和罩衣的情况。
我们使用了超过 40000 名护士参与的护士健康研究 3 的数据。通过问卷，报告了过去一个月（非孕妇护士）或妊娠前 20 周（孕妇护士）内使用手套和罩衣以及管理抗肿瘤药物的情况。
36%的非孕妇护士报告在其职业生涯中曾接触过抗肿瘤药物，其中 27%的护士报告在过去一个月内接触过这些药物。7%的孕妇护士报告在妊娠前 20 周内接触过抗肿瘤药物。12%的非孕妇护士和 9%的孕妇护士表示，在接触抗肿瘤药物时从不戴手套，42%的非孕妇护士和 38%的孕妇护士报告从不使用罩衣。报告未戴手套接触抗肿瘤药物的非孕妇护士的百分比因给药方式而异：仅给予粉碎药丸的护士中，32%的人从未戴过手套，而仅通过输注给药的护士中，这一比例为 5%。
尽管长期以来一直建议安全处理抗肿瘤药物和其他危险药物，但许多护士——包括孕妇——报告说，他们不戴防护手套和罩衣，而在管理这些药物时，这些被认为是最低限度的防护设备。这些发现突显了需要进一步教育和培训，以确保雇主和护士都了解所涉及的风险，并了解哪些预防措施将最大限度地减少此类接触。
