Occupational Exposure to Antineoplastic Drugs and Nursing
Yıl: 2020 Cilt: 7 Sayı: 2 Sayfa Aralığı: 207 - 212 Metin Dili: İngilizce DOI: 10.5152/ArcHealthSciRes.2020.572072 İndeks Tarihi: 30-10-2020
Occupational Exposure to Antineoplastic Drugs and Nursing
Öz: Health workers are exposed to antineoplastic drugs when working in the preparation and management of antineoplastic drugs or in the place where these drugs are used. The development of oncology as a field of expertise in medicine, the increase of chemotherapy doses and combinations given to cancer patients, and the development of a supportive care area to help minimize or protect from the side effects of chemotherapy increase the occupational exposure of nurses to antineoplastic drugs. Occupational exposure to antineoplastic drugs has many side effects and health problems in healthcare workers. This exposure may cause acute side effects such as skin rash, nausea, vomiting, diarrhea, constipation, alopecia, nail hyperpigmentation, dysuria, and insomnia, or chronic side effects such as infertility, miscarriage, damage to the fetus and embryo, leukemia, and breast cancer. Therefore, the aim of this review is to evaluate the occupational exposure of nurses working with antineoplastic drugs and the preventive measures.
Anahtar Kelime: Antineoplastik İlaçlara Mesleki Maruziyet ve Hemşirelik
Öz: Sağlık çalışanları antineoplastik ilaçların hazırlanması ve yönetimini gerçekleştirirken veya bu ilaçların kullanıldığı alanlarda çalışırken bu ilaçlara maruz kalmaktadır. Tıpta uzmanlık alanı olarak onkolojinin gelişmesi, kanser hastalarına verilen kemoterapi doz ve kombinasyonlarının artması, kemoterapinin yan etkilerini minimuma indirmek ve korumaya yardımcı olmak için destekleyici bakım alanının gelişmesi hemşirelerin antineoplastik ilaçlara olan maruziyetini arttırmaktadır. Antineoplastik ilaçlara mesleki maruziyetin sağlık çalışanlarında yarattığı birçok yan etki ve sağlık sorunu bulunmaktadır. Antineoplastik ilaçlara mesleki maruziyet, cilt döküntüsü, bulantı, kusma, diyare, konstipasyon, alopesi, tırnaklarda hiperpigmentasyon, dizüri, uykusuzluk gibi akut yan etkilere, infertilite, abortus, fetüs ve embriyoda hasar, lösemi ve meme kanseri gibi kronik yan etkilere neden olmaktadır. Bu nedenle bu derleme çalışmasının amacı antineoplastik ilaçlar ile çalışan hemşirelerin mesleki maruziyetlerinin ve korunma önlemlerinin değerlendirilmesidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
- 1. WHO. Occupational Health: Health Worker Occupational Health. Available from: https://www.who.int/occupational_health/topics/ hcworkers/en/.
- 2. Occupational Safety and Health Administration (OSHA). Healthcare. Available from: https://www.osha.gov/SLTC/healthcarefacilities /index.html.
- 3. ASHP. ASHP Technical Assistance Bulletin on Handling Cytotoxic and Hazardous Drugs. Am J Hosp Pharm 1990; 47: 1033-49.
- 4. The National Institute for Occupational Safety and Health (NIOSH). Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. 2004. Availabe from: https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf?id=10.26616/NIOSHPUB2004165.
- 5. Connor TH, MacKenzie BA, DeBord DG, Trout DB, O'Callaghan JP. NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016. Cincinnati, Ohio: US. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupa¬tional Safety and Health, DHHS (NIOSH). https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf
- 6. Polovich M. Minimizing Occupational Exposure to Antineoplastic Agents. J Infus Nurs 2016; 39: 307-13.
- 7. Wang X, Zhang H, Chen X. Drug resistance and Combating Drug Resistance in Cancer. Canc Drug Resist 2019; 2: 141-60.
- 8. Al-Azzam SI, Awawdeh BT, Alzoubi KH, Khader YS, Alkafajei AM. Compliance With Safe Handling Guidelines of Antineoplastic Drugs in Jordanian Hospitals. J Oncol Pharm Pract 2015; 21: 3-9.
- 9. Amadori D, Ronconi S. Secondary lung tumors in hematological patients. Semin Respir Crit Care Med 2005; 26: 520-6.
- 10. Gombos DS, Hungerford J, Abramson DH, Kingston J, Chantada G, Dunkel IJ, et al. Secondary Acute Myelogenous Leukemia in Patients with Retinoblastoma: ıs Chemotherapy A Factor? Ophthalmology 2007; 114: 1378-83.
- 11. Sugiura SI, Asano M, Kinoshita K, Tanimura M, Nabeshima T. Risks to Health Professionals from Hazardous Drugs in Japan: A Pilot Study of Environmental and Biological Monitoring of Occupational Exposure to Cyclophosphamide. J Oncol Pharm Pract 2011; 17: 14-9.
- 12. Onkoloji Hemşireliği Derneği. Antineoplastik İlaçların Güvenli Kullanım Standartları Rehberi. 2009. Available from: http://www.onkohem.org.tr/dosyalar/1286610
- 13. Nixon S,Schulmeister L. Safe handling of Hazardous Drugs: Are You Protected? Clin J Oncol Nurs 2009; 13: 433-9.
- 14. Eisenberg S. Safe handling and Administration of Antineoplastic Chemotherapy. J Infus Nurs 2009; 32: 23-32.
- 15. Celano P, Fausel CA, Kennedy EB, Miller TM, Oliver TK, Page R, et al. (2019). Safe Handling of Hazardous Drugs: ASCO Standards. J Clin Oncol 2019: 598-609.
- 16. Occupational Safety and Health Administration (OSHA). Guidelines for Cytotoxic (Antineoplastic) Drugs. 1986. Avalaible from: https://www.osha.gov/enforcement/directives/std-01-23-001.
- 17. T.C. Sağlık Bakanlığı Tedavi Hizmetleri Genel Müdürlüğü. Antineoplastik (Sitotoksik) İlaçlarla Güvenli Çalışma Rehberi. Ankara, 2004. Available from: https://www.sbn.gov.tr/icerikdosyalar /2063686233_antineoplastik(sitotoksik)_ilaclarla_guvenli_calisma_rehberi.pdf.
- 18. Connor TH, McDiarmid MA. Preventing Occupational Exposures to Antineoplastic Drugs in Health Care Settings. CA Cancer J Clin 2006; 56: 354-65.
- 19. Polovich M. Safe Handling of Hazardous Drugs. Online J Issues Nurs 2004; 9: Manuscript 5. Available from: https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No3Sept04/HazardousDrugs.html
- 20. Hedmer M, Höglund P, Cavallin-Ståhl E, Albin M, Jönsson BA. Validation of Urinary Excretion of Cyclophosphamide as a Biomarker of Exposure by Studying Its Renal Clearance at High and Low Plasma Concentrations in Cancer Patients. Int Arch Occup Environ Health 2008; 81: 285-93.
- 21. Wyeth. Temsirolimus [Package Insert] 2018. Available from: http://labeling.pfizer.com/showlabeling.aspx?id=490#section-11.3
- 22. Mader RM, Rizovski B, Steger GG, Wachter A, Kotz R, Rainer H. Exposure of Oncologic Nurses to Methotrexate in the Treatment of Osteosarcoma. Arch Environ Health 1996; 51: 310-4.
- 23. Valanis BG, Vollmer WM, Labuhn KT, Glass AG. Acute Symptoms Associated with Antineoplastic Drug Handling among Nurses". Cancer nursing, 1993;16(4), 288-295.
- 24. Constantinidis TC, Vagka E, Dallidou P, Basta P, Drakopoulos V, Kakolyris S, et al. Occupational Health and Safety of Personnel Handling Chemotherapeutic Agents in Greek Hospitals. Eur J Cancer Care (Engl) 2011; 20: 123-31.
- 25. Unsar S, Kurt S, Kostak MA., Yaman R, Özcan M. Determination of Antineoplastic Drug Exposure of Nurses at a University Hospital. Int J Caring Sci 2016; 9: 314.
- 26. El Samra GH, Gaballah IM, Rashed LA, Shehata RA. Adverse Health Effect of Occupational Exposure to Cisplatin among Health care Workers. Egypt J Occup Med 2018; 42: 181-94
- 27. Riley SL. Compliance to the National Guidelines for the Safe handling of Antineoplastic Agents by Oncology Registered Nurses (Master’s Thesis). Northern Kentucky University, Nursing Department, Kentucky, USA. 2009
- 28. Blair A, Zheng T, Linos A, Stewart PA, Zhang YW, Cantor KP. Occupation and Leukemia: A Population‐Based Case-Control Study in Iowa and Minnesota". Am J Ind Med 2001; 40: 3-14.
- 29. Skov T, Maarup B, Olsen J, Rørth M, Winthereik H, Lynge E. Leukemia and Reproductive Outcome among Nurses Handling Antineoplastic Drugs Br J Ind Med 1992; 49: 855-61.
- 30. Fransman W, Roeleveld N, Peelen S, de Kort W, Kromhout H, Heederik D. Nurses with Dermal Exposure to Antineoplastic Drugs: Reproductive Outcomes. Epidemiology 2007; 18: 112-9.
- 31. Hopf NB, Bolognesi C, Danuser B, Wild P. Biological Monitoring of Workers Exposed to Carcinogens Using the Buccal Micronucleus Approach: A systematic Review and Meta-Analysis. Mutat Res 2019; 781: 11-29.
- 32. Selevan SG, Lindbohm ML, Hornung RW, Hemminki K. A Study of Occupational Exposure to Antineoplastic Drugs and Fetal Loss in Nurses". N Engl J Med 1985; 313: 1173-8.
- 33. Lawson CC, Rocheleau CM, Whelan EA, Hibert ENL, Grajewski B, Spiegelman D, et al. Occupational exposures among nurses and risk of spontaneous abortion. Am J Obstet Gynecol 2012; 206: 327.e1-8
- 34. Hemminki K, Kyyrönen P, Lindbohm ML. Spontaneous Abortions and Malformations in the Offspring of Nurses Exposed to Anaesthetic Gases, Cytostatic Drugs, and Other Potential Hazards in Hospitals, Based on Registered Information of Outcome. J Epidemiol Community Health 1985; 39: 141-7.
- 35. Ursini CL, Salè EO, Fresegna AM, Ciervo A, Jemos C, Maiello R, et al. Antineoplastic Drug Occupational Exposure: A New İntegrated Approach to Evaluate Exposure and Early Genotoxic and Cytotoxic Effects by No-İnvasive Buccal Micronucleus Cytome Assay Biomarker. Toxicol Lett 2019; 316: 20-6.
- 36. Moretti M, Bonfiglioli R, Feretti D, Pavanello S, Mussi F, Grollino MG, et al. A Study Protocol for the Evaluation of Occupational Mutagenic/Carcinogenic Risks in Subjects Exposed to Antineoplastic Drugs: A Multicentric Project. BMC Public Health 2011; 11: 195.
- 37. Eghbal MA, Yusefi E, Tavakoli-Ardakani M, Ramazani M, Zarei MH, Salimi A, et al. Exposure to Antineoplastic Agents Induces Cytotoxicity in Nurse Lymphocytes: Role of Mitochondrial Damage and Oxidative Stress. Iran J Pharm Sci 2018; 17(Suppl): 43.
- 38. Rombaldi F, Cassini C, Salvador M, Saffi J, Erdtmann B. Occupational Risk Assessment of Genotoxicity and Oxidative Stress in Workers Handling Antineoplastic Drugs during A Working Week. Mutagenesis 2009; 24: 143-8.
- 39. Mahmoodi M, Soleyman-Jahi S, Zendehdel K, Mozdarani H, Azimi C, Farzanfar F, et al. Chromosomal aberrations, sister chromatid exchanges, and micronuclei in lymphocytes of oncology department personnel handling anti-neoplastic drugs. Drug Chem Toxicol 2017; 40: 235-40.
- 40. El-Ebiary AA, Abuelfadl AA, Sarhan NI. Evaluation of Genotoxicityinduced by Exposure to Antineoplastic Drugs in Lymphocytes of Oncology Nurses and Pharmacists. J Appl Toxicol 2013; 33: 196-201.
- 41. Cavallo D, Ursini CL, Perniconi B, Di Francesco A, Giglio M, Rubino FM, et al. Evaluation of Genotoxic Effects İnduced By Exposure To Antineoplastic Drugs İn Lymphocytes and Exfoliated Buccal Cells of Oncology Nurses and Pharmacy Employees. Mutat Res 2005; 587: 45-51.
- 42. Cornetta T, Padua L, Testa A, Ievoli E, Festa F, Tranfo G, Molecular Biomonitoring of A Population of Nurses Handling Antineoplastic Drugs. Mutat Res 2008; 638: 75-82.
- 43. Gómez-Oliván LM, Miranda-Mendoza GD, Cabrera-Galeana PA, Galar-Martínez M, Islas-Flores H, SanJuan-Reyes N, et al. Oxidative Stress Induced in Nurses by Exposure to Preparation and Handling of Antineoplastic Drugs in Mexican Hospitals: A Multicentric Study". Oxid Med Cell Longev 2014; 2014:858604.
- 44. Izdes S, Sardas S, Kadioglu E, Kaymak C, Ozcagli E. Assessment of Genotoxic Damage in Nurses Occupationally Exposed to Anaesthetic Gases or Antineoplastic Drugs by the Comet Assay. J Occup Health 2009; 51: 283-6.
- 45. Sertler Ş. Sağlık Personelinde Antineoplastik İlaçlarla Güvenli Çalışma Durumu ile Biyolojik ve Çevresel Kontaminasyonun Değerlendirilmesi. (Doktora Tezi). İstanbul Üniversitesi Adli Tıp Enstitüsü Sosyal Bilimler Anabilim Dalı, İstanbul, Türkiye. 2013.
- 46. The National Institute for Occupational Safety and Health (NIOSH). Available from: https://www.cdc.gov/ niosh/topics/hierarchy/default.html.
| APA | TOPÇU S, Beser A (2020). Occupational Exposure to Antineoplastic Drugs and Nursing. , 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| Chicago | TOPÇU Sevcan,Beser Ayse Occupational Exposure to Antineoplastic Drugs and Nursing. (2020): 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| MLA | TOPÇU Sevcan,Beser Ayse Occupational Exposure to Antineoplastic Drugs and Nursing. , 2020, ss.207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| AMA | TOPÇU S,Beser A Occupational Exposure to Antineoplastic Drugs and Nursing. . 2020; 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| Vancouver | TOPÇU S,Beser A Occupational Exposure to Antineoplastic Drugs and Nursing. . 2020; 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| IEEE | TOPÇU S,Beser A "Occupational Exposure to Antineoplastic Drugs and Nursing." , ss.207 - 212, 2020. 10.5152/ArcHealthSciRes.2020.572072 |
| ISNAD | TOPÇU, Sevcan - Beser, Ayse. "Occupational Exposure to Antineoplastic Drugs and Nursing". (2020), 207-212. https://doi.org/10.5152/ArcHealthSciRes.2020.572072 |
| APA | TOPÇU S, Beser A (2020). Occupational Exposure to Antineoplastic Drugs and Nursing. Archives of health science and research (Online), 7(2), 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| Chicago | TOPÇU Sevcan,Beser Ayse Occupational Exposure to Antineoplastic Drugs and Nursing. Archives of health science and research (Online) 7, no.2 (2020): 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| MLA | TOPÇU Sevcan,Beser Ayse Occupational Exposure to Antineoplastic Drugs and Nursing. Archives of health science and research (Online), vol.7, no.2, 2020, ss.207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| AMA | TOPÇU S,Beser A Occupational Exposure to Antineoplastic Drugs and Nursing. Archives of health science and research (Online). 2020; 7(2): 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| Vancouver | TOPÇU S,Beser A Occupational Exposure to Antineoplastic Drugs and Nursing. Archives of health science and research (Online). 2020; 7(2): 207 - 212. 10.5152/ArcHealthSciRes.2020.572072 |
| IEEE | TOPÇU S,Beser A "Occupational Exposure to Antineoplastic Drugs and Nursing." Archives of health science and research (Online), 7, ss.207 - 212, 2020. 10.5152/ArcHealthSciRes.2020.572072 |
| ISNAD | TOPÇU, Sevcan - Beser, Ayse. "Occupational Exposure to Antineoplastic Drugs and Nursing". Archives of health science and research (Online) 7/2 (2020), 207-212. https://doi.org/10.5152/ArcHealthSciRes.2020.572072 |
