梅小红, 黄超, 张艳芳, 陈昌蕊, 李佳, 尚振秋, 黄小红. 医护人员职业接触抗肿瘤药物不良妊娠结局及其影响因素调查[J]. 职业卫生与应急救援, 2022, 40(4): 417-423. DOI: 10.16369/j.oher.issn.1007-1326.2022.04.006
引用本文: 梅小红, 黄超, 张艳芳, 陈昌蕊, 李佳, 尚振秋, 黄小红. 医护人员职业接触抗肿瘤药物不良妊娠结局及其影响因素调查[J]. 职业卫生与应急救援, 2022, 40(4): 417-423. DOI: 10.16369/j.oher.issn.1007-1326.2022.04.006
MEI Xiaohong, HUANG Chao, ZHANG Yanfang, CHEN Changrui, LI Jia, SHANG Zhenqiu, HUANG Xiaohong. Investigation on adverse pregnancy outcomes and influencing factors of medical staff exposed to antineoplastic drugs[J]. Occupational Health and Emergency Rescue, 2022, 40(4): 417-423. DOI: 10.16369/j.oher.issn.1007-1326.2022.04.006
Citation: MEI Xiaohong, HUANG Chao, ZHANG Yanfang, CHEN Changrui, LI Jia, SHANG Zhenqiu, HUANG Xiaohong. Investigation on adverse pregnancy outcomes and influencing factors of medical staff exposed to antineoplastic drugs[J]. Occupational Health and Emergency Rescue, 2022, 40(4): 417-423. DOI: 10.16369/j.oher.issn.1007-1326.2022.04.006

医护人员职业接触抗肿瘤药物不良妊娠结局及其影响因素调查

Investigation on adverse pregnancy outcomes and influencing factors of medical staff exposed to antineoplastic drugs

  • 摘要:
      目的  调查职业接触抗肿瘤药物(antineoplastic drugs,ADs)医护人员不良妊娠结局现状,探讨其影响因素,改善医护人员职业防护。
      方法  对深圳市3家医院235名医护人员进行问卷调查,其中接触组119人(孕次153次),对照组116人(孕次156次)。获取两组研究对象一般资料,比较两组不良妊娠结局(自然流产、胚胎停止发育、畸胎及死胎)发生率,并采用二元logistic回归分析接触组发生不良妊娠结局的影响因素。
      结果  接触组22名医护人员发生不良妊娠结局,其不良妊娠结局发生率为18.5%,接触组发生不良妊娠结局的风险是对照组的8.543倍(P < 0.001)。二元logistic回归分析结果显示:ADs接触年限增加(OR = 1.181,95%CI = 1.004 ~ 1.389,P = 0.044)是医护人员不良妊娠结局的危险因素,参与医院开设课程(OR = 0.185,95%CI = 0.036 ~ 0.954)、科室培训(OR = 0.056,95%CI = 0.005 ~ 0.633)及同事间交流学习ADs相关危害知识(OR = 0.094,95%CI = 0.015 ~ 0.605)、处理ADs时使用N95及以上口罩(OR = 0.127,95%CI = 0.021 ~ 0.782)、佩戴双层乳胶手套(OR = 0.071,95%CI = 0.008 ~ 0.612)是不良妊娠结局的保护因素(P < 0.05)。
      结论  职业接触ADs可导致不良妊娠结局的风险增加,应采取积极的防护措施,提高医护人员防护意识,改善职业安全现状,最大化减少ADs带来的职业危害。

     

    Abstract:
      Objective  To investigate the adverse pregnancy outcomes of medical staff exposed to antineoplastic drugs (ADs), explore its influencing factors, and improve the occupational safety of these medical staff.
      Methods  A questionnaire survey was conducted among 235 medical staff in three hospitals in Shenzhen, including 119 in the exposed group (153 pregnancies) and 116 in the non-exposed group (156 pregnancies). The general data of subjects were obtained, and the incidence of adverse pregnancy outcomes (spontaneous abortion, embryonic arrest, teratogenesis and stillbirth) was compared between the two groups. The influencing factors of adverse pregnancy outcomes in the exposed group were analyzed by binary logistic regression.
      Results  Totally 22 medical and nursing staff in the exposed group had adverse pregnancy outcomes, and the incidence of adverse pregnancy outcomes was 18.5%. The risk of adverse pregnancy outcomes was 8.543 times higher than that in the non-exposed group (P < 0.001). The results of binary logistic regression analysis showed that longer time of exposure to ADs (OR = 1.181, 95%CI = 1.004 - 1.389, P = 0.044) was a risk factor for adverse pregnancy outcomes of medical staff. Participating in related courses organized by hospital (OR = 0.185, 95% CI = 0.036-0.954), participating in training organized by department (OR = 0.056, 5%CI = 0.005-0.633) and exchanging with colleagues about knowledge of ADS-related hazard (OR = 0.094, 95%CI = 0.015-0.605), using N95 or above mask (OR = 0.127, 95% CI = 0.021-0.782) and wearing double latex gloves (OR = 0.071, 95% CI = 0.008-0.612) when dealing with ADs were protective factors for adverse pregnancy outcomes (P < 0.05).
      Conclusions  Occupational exposure to ADs could increase the risk of adverse pregnancy outcomes. Effect protective measures should be taken to improve the protection awareness of medical staff, improve the current situation of occupational safety, and minimize the occupational hazards caused by ADs.

     

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