Christina C Lawson1, Candice Y Johnson, Feiby L Nassan, Thomas H Connor, James M Boiano, Carissa M Rocheleau, Jorge E Chavarro, Janet W Rich-Edwards. 1. 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, clawson@cdc.gov. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
Abstract
: 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. PURPOSE: This study assessed glove and gown use by female pregnant and nonpregnant nurses who administer antineoplastic drugs in the United States and Canada. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
: 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. PURPOSE: This study assessed glove and gown use by female pregnant and nonpregnant nurses who administer antineoplastic drugs in the United States and Canada. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Thomas H Connor; D Gayle DeBord; Jack R Pretty; Marc S Oliver; Tracy S Roth; Peter S J Lees; Edward F Krieg; Bonnie Rogers; Carmen P Escalante; Christine A Toennis; John C Clark; Belinda C Johnson; Melissa A McDiarmid Journal: J Occup Environ Med Date: 2010-10 Impact factor: 2.162
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Authors: Feiby L Nassan; Christina C Lawson; Audrey J Gaskins; Candice Y Johnson; James M Boiano; Janet W Rich-Edwards; Jorge E Chavarro Journal: Am J Ind Med Date: 2019-06-20 Impact factor: 2.214
Authors: Feiby L Nassan; Jorge E Chavarro; Candice Y Johnson; James M Boiano; Carissa M Rocheleau; Janet W Rich-Edwards; Christina C Lawson Journal: Ann Epidemiol Date: 2020-09-11 Impact factor: 3.797