Feiby L Nassan1,2, Christina C Lawson3, Audrey J Gaskins2,4, Candice Y Johnson3, James M Boiano3, Janet W Rich-Edwards5,4,6, Jorge E Chavarro2,5,4. 1. Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 2. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 3. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio. 4. Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts. 5. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 6. Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: We examined the association between the administration of antineoplastic drugs (AD) and fecundity among female nurses. METHODS: AD administration and use of exposure controls (EC) such as gloves, gowns, and needleless systems were self-reported at baseline among 2649 participants of the Nurses' Health Study 3, who were actively attempting pregnancy. Every 6 months thereafter, the nurses reported the current duration of their pregnancy attempt. Multivariable accelerated failure time models were used to estimate time ratios (TR) and 95% confidence intervals (CI) adjusted for age, race, body mass index, smoking, marital status, hours of work, and other occupational risk factors. RESULTS: Mean (standard deviation) age and BMI at baseline were 30.7 years (4.7) and 26.0 kg/m2 (6.4). Forty-one percent of nurses reported ever administering AD; 30% only in the past and 11% currently. The former administration of AD (TR = 1.02, 95% CI, 0.93-1.12) was unrelated to the ongoing duration of pregnancy attempt. Among nurses currently administering AD, those who had administered AD for 6 years and above had a 27% (95% CI, 6%-53%) longer duration of pregnancy attempt than nurses who never handled ADs in unadjusted analyses. This difference disappeared in multivariable analyses (TR = 1.01, 95% CI, 0.85-1.21). 93% (n = 270) of the nurses currently administering ADs reported consistent use of EC. These nurses had a similar median duration of pregnancy attempt to those who never handled AD (TR = 1.00, 95% CI, 0.87-1.15). CONCLUSIONS: Administration of ADs did not appear to have an impact on fecundity in a cohort of nurses planning for pregnancy with a high prevalence of consistent ECs. Our results may not be generalizable to women who are less compliant with PPE use or with less availability to ECs. Therefore, it is possible that we did not observe an association between occupational exposure to AD and reduced fecundity because of lower exposure due to the more prevalent use of effective ECs.
BACKGROUND: We examined the association between the administration of antineoplastic drugs (AD) and fecundity among female nurses. METHODS:AD administration and use of exposure controls (EC) such as gloves, gowns, and needleless systems were self-reported at baseline among 2649 participants of the Nurses' Health Study 3, who were actively attempting pregnancy. Every 6 months thereafter, the nurses reported the current duration of their pregnancy attempt. Multivariable accelerated failure time models were used to estimate time ratios (TR) and 95% confidence intervals (CI) adjusted for age, race, body mass index, smoking, marital status, hours of work, and other occupational risk factors. RESULTS: Mean (standard deviation) age and BMI at baseline were 30.7 years (4.7) and 26.0 kg/m2 (6.4). Forty-one percent of nurses reported ever administering AD; 30% only in the past and 11% currently. The former administration of AD (TR = 1.02, 95% CI, 0.93-1.12) was unrelated to the ongoing duration of pregnancy attempt. Among nurses currently administering AD, those who had administered AD for 6 years and above had a 27% (95% CI, 6%-53%) longer duration of pregnancy attempt than nurses who never handled ADs in unadjusted analyses. This difference disappeared in multivariable analyses (TR = 1.01, 95% CI, 0.85-1.21). 93% (n = 270) of the nurses currently administering ADs reported consistent use of EC. These nurses had a similar median duration of pregnancy attempt to those who never handled AD (TR = 1.00, 95% CI, 0.87-1.15). CONCLUSIONS: Administration of ADs did not appear to have an impact on fecundity in a cohort of nurses planning for pregnancy with a high prevalence of consistent ECs. Our results may not be generalizable to women who are less compliant with PPE use or with less availability to ECs. Therefore, it is possible that we did not observe an association between occupational exposure to AD and reduced fecundity because of lower exposure due to the more prevalent use of effective ECs.
Authors: Wouter Fransman; Nel Roeleveld; Susan Peelen; Wim de Kort; Hans Kromhout; Dick Heederik Journal: Epidemiology Date: 2007-01 Impact factor: 4.822
Authors: Maureen A Cooney; Germaine M Buck Louis; Rajeshwari Sundaram; Bridget M McGuiness; Courtney D Lynch Journal: Epidemiology Date: 2009-01 Impact factor: 4.822
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