Prepregnancy Handling of Antineoplastic Drugs and Risk of Miscarriage in Female Nurses

Details

• Personal Author:
  Boiano, James M. ; Chavarro JE ; Johnson CY ; Lawson, Christina C. ; Nassan FL ; Rich-Edwards JW ; Rocheleau CM
• Description:
  Objective: To examine the association between handling of antineoplastic drugs (AD), use of exposure controls, and risk of miscarriage. Methods: Women in the Nurses' Health Study 3 self-reported AD administration and use of engineering controls (EC) and personal protective equipment (PPE) at baseline. Nurses who reported pregnancies after baseline were included in this analysis. We estimated the Hazard Ratio (HR) of miscarriage in relation to baseline AD handling using multivariable Cox proportional regression modified for discrete time data. Results: 2,440 nurses reported 3,327 pregnancies within a median of 3 years after baseline (range:1-8 years), of which 550 (17%) ended as miscarriages. Mean (standard deviation) age at baseline was 29.7 years (4.3). At baseline, 12% of the nurses self-reported currently handling AD and 28% previously handling. Compared to nurses who never handled AD, nurses who handled AD at baseline had a HR of miscarriage of 1.26 (95% CI: 0.97, 1.64) after adjusting for age, body mass index, and smoking. This association was stronger for losses after 12 weeks gestation (HR=2.39 [95% CI: 1.13, 5.07]), and among nurses who did not always use EC and PPE. Nurses who did not always use gloves had a HR of 1.51 (95% CI:0.91, 2.51) compared to 1.19 (95% CI:0.89, 1.60) for those always using gloves; nurses who did not always use gowns had a HR of 1.32 (95% CI:0.95, 1.83) compared to 1.19 (95% CI:0.81, 1.75) for nurses always using gowns. AD handling prior to baseline was unrelated to risk of miscarriage. Conclusion(s): We observed a suggestive positive association between AD handling and miscarriage, particularly among nurses who did not consistently use PPE and EC. These associations appeared to be more evident among second trimester losses. [Description provided by NIOSH]
• Subjects:
  Aging Engineering Epidemiology Hazardous Substances Health Personnel Occupational Health Personal Protective Equipment Pregnancy Safety
• Keywords:
  Age Groups Antineoplastic Agents Author Keywords: Antineoplastic Drugs Engineering Controls Exposure Controls Hazardous Drugs Miscarriage Nurses Nurses Health Study Occupational Exposure Personal Protective Equipment PPE Surveillance

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• ISSN:
  1047-2797
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; Ohio ; OSHA Region 1 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  53
• NIOSHTIC Number:
  nn:20061065
• Citation:
  Ann Epidemiol 2021 Jan; 53:95-102.e2
• Contact Point Address:
  Feiby L. Nassan, Sc.D., Harvard T.H. Chan School of Public Health, Building II 3rd Floor, 655 Huntington Avenue, Boston, MA 02115
• Email:
  fen769@mail.harvard.edu
• Federal Fiscal Year:
  2021
• Peer Reviewed:
  True
• Source Full Name:
  Annals of Epidemiology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ea417ea6d1a98cb03a6be57af0caf280801a593a7c3fada3ac714402d3f7df1ddebf47719af861be8cefe41852224726416d0ce04d0fd4f94f45329e7a554eb3
• Download URL:
  https://stacks.cdc.gov/view/cdc/224743/cdc_224743_DS1.pdf
• File Type:
  [PDF - 836.45 KB ]