Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard School of Public Health, Boston, MA, USA.
Syst Rev. 2020 Oct 19;9(1):242. doi: 10.1186/s13643-020-01494-4.
Occupational exposure to cytotoxic drugs is associated with various unfavorable health outcomes. This protocol reports a methodology for a systematic review and meta-analysis that aims to systematically review the published literature and quantify the level of environmental contamination of healthcare settings with cytotoxic drugs.
This protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol-2015 (PRISMA-P) guidelines. Six electronic databases (PubMed, Web of Science, Scopus, Cochrane Library, CINAHL, and EMBASE) will be searched with no restrictions on publication period. Eligible studies will be identified and data will be extracted using a predefined data extraction form by at least two independent reviewers following best practice. Eligible studies should report calculated or calculable estimates on the proportion of positive samples tested for cytotoxic drugs and/or estimates on the concentration of the cytotoxic drug(s) in the tested samples. Risk of bias (RoB) will be assessed by using the RoB in Studies estimating Prevalence of Exposure to Occupational risk factors (RoB-SPEO) tool, which developed by the World Health Organization (WHO) and International Labour Organization (ILO) for environmental and occupational health systematic reviews. The random-effects model will be used to perform meta-analyses.
Occupational exposure to cytotoxic drugs is associated with short- and long-term adverse health outcomes. Following this protocol, the review to be carried out will be the first to fill an evidence gap on the environmental contamination of healthcare settings with cytotoxic drugs. The findings of this review will help in the understanding of the risk of occupational exposure of healthcare workers to cytotoxic drugs and facilitate the identification of priority areas for specific interventions.
The systematic review methodology does not require ethics approval due to the nature of the study design. The results of the systematic review will be published in a peer-reviewed journal and will be publicly available.
PROSPERO CRD42020162780 , dated July 14, 2020.
职业性接触细胞毒性药物与各种不良健康后果有关。本方案报告了一项系统评价和荟萃分析的方法学，旨在系统地综述已发表的文献，并量化医疗机构中细胞毒性药物的环境污染水平。
本方案是按照 2015 年系统评价和荟萃分析报告的首选条目（PRISMA-P）指南制定的。将对 6 个电子数据库（PubMed、Web of Science、Scopus、Cochrane Library、CINAHL 和 EMBASE）进行无发表时间限制的搜索。将通过至少两名独立审查员使用预定义的数据提取表来识别合格研究并提取数据，遵循最佳实践。合格研究应报告针对细胞毒性药物进行的阳性样本测试的计算或可计算的比例，或测试样本中细胞毒性药物浓度的估计值。将使用世界卫生组织（WHO）和国际劳工组织（ILO）为环境和职业健康系统评价制定的暴露于职业风险因素的研究中（RoB-SPEO）工具评估偏倚风险（RoB）。将使用随机效应模型进行荟萃分析。
职业性接触细胞毒性药物与短期和长期不良健康后果有关。按照本方案，将要进行的审查将是第一个填补医疗机构细胞毒性药物环境污染证据空白的审查。本综述的结果将有助于了解医护人员接触细胞毒性药物的职业暴露风险，并有助于确定具体干预措施的优先领域。
由于研究设计的性质，系统评价方法不需要伦理批准。系统评价的结果将发表在同行评议的期刊上，并公开发布。
PROSPERO CRD42020162780，日期为 2020 年 7 月 14 日。
