Dermal Exposure to Chemotherapy Drugs Impairs Fertility in Nurses

Sunday, January 21st 2007

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Oncology nurses who are exposed through their skin to antineoplastic drugs take longer to conceive and are at increased risk for premature delivery, according to a report in the January issue of Epidemiology.

"Nine antineoplastic drugs have been classified as proven carcinogenic to humans by the International Agency for Research on Cancer (IARC)," Dr. Wouter Fransman told Reuters Health. "Our findings show that even very low dermal exposure levels (nanograms) can cause an elevated risk of a prolonged time to pregnancy, premature delivery, or a low birth weight, even when gloves are worn during work."

"We hope that people working with antineoplastic drugs are aware of the potential risks of these agents," Dr. Fransman said. "We should not scare people too much, but on the other hand we should not ignore the potential health risks that are associated with exposure to antineoplastic drugs. The awareness on how to safely work with these agents and following the right protocols and regulations will minimize exposure and hence reduce health risks."

Dr. Fransman from Utrecht University, The Netherlands and colleagues used questionnaires to assess pregnancy outcomes, work-related exposures, and lifestyle factors among 4393 oncology nurses, 1519 of which reported dermal exposure to antineoplastic drugs during the course of their work.

On average, nurses with dermal exposure to antineoplastic drugs took one month longer than unexposed nurses to get pregnant, the authors report.

Moreover, exposed nurses were twice as likely as unexposed nurses to deliver a low birthweight child, the results indicate.

Dermal exposure to antineoplastic drugs also slightly increased the risk of premature delivery, the researchers note, but there was not a significantly increased risk of stillbirth, spontaneous abortion, or congenital malformations.

Dr. Fransman commented that his group hopes to extend the study to other countries, where exposure levels may differ. "Maybe exposure levels in other countries are much higher, so that we can test our hypothesis that higher exposure levels could lead to fetal loss and congenital malformations."

Epidemiology 2007;18:112-119

By Will Boggs, MD

 

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