Evaluation of consequences of occupational exposure to carcinogens in various branches of industry
Authors:
O. Vencálek 1; Z. Šmerhovský 1,2; K. Landa 1
Authors‘ workplace:
Státní zdravotní ústav, Praha
Ředitel: MUDr. Milan Bořek
1; Univerzita Karlova v Praze
2. lékařská fakulta, Praha
Děkan: doc. MUDr. Ondřej Hrušák, Ph. D.
2
Published in:
Prakt. Lék. 2009; 89(6): 290-294
Category:
Reviews
Overview
This retrospective epidemiologic study is aimed at the health status of a cohort of 7 942 subjects occupationally exposed to carcinogens in different sectors of the Czech economy in the period 1998–2007, including 3 586 health care providers. By means of Cox regression model, comparing an occurrence of cancer in the groups defined according to occupation in the different economic sectors, we found that besides expected factors such as age, gender, and smoking, the risk of cancer was increased in health care providers (HR=1.49, 95% CI=(1.05–2.10), p=0.024) and in subjects simultaneously exposed to more than two carcinogens (HR=2.35, 95% CI=(1.15–4.83), p=0.019). The fact that 84.5 % of the health care providers were followed up because of occupational exposure to cytostatic drugs may explain the increased risk of cancer in this particular occupational group.
Key words:
occupational exposure to carcinogens, risk of cancer, cytostatic drugs, survival analysis, Cox regression, surveillance.
Sources
1. Hemminki, K., Kyyronen, P., Lindbohm, M.L. Spontaneous-abortions and malformations in the offspring of nurses exposed to anesthetic-gases, cytostatic drugs, and other potential hazardsin hospitals, based on registered information of outcome. J. Epidemiol. Community Health 1985, 39(2), p. 141-147.
2. Hosmer, D.W., Lemeshow, S. Applied Survival Analysis. New York: John Wiley & Sons, 1999.
3. McDevitt, J.J., Lees, P.S., McDiarmid, M.A. Exposure of hospital pharmacists and nurses to antineoplastic agents. J. Occup. Med. 1993, 35(1), p. 57-60.
4. McDiarmid, M.A., Kolodner, K., Humphrey, F. et al. Baseline and phosphoramide mustard-induced sister-chromatid exchanges in pharmacists handling anti-cancer drugs. Mutat. Res. 1992, 279(3), p. 199-204.
5. Overall Evaluations of Carcinogenicity to Humans - Carcinogenic to humans [on line]. Dostupný na WWW: http://monographs.iarc.fr/ENG/ Classification/crthgr01.php
6. Overall Evaluations of Carcinogenicity to Humans - Possibly carcinogenic to humans [on line]. Dostupný na WWW:
http://monographs.iarc.fr/ENG/Classification/crthgr02b.php
7. Overall Evaluations of Carcinogenicity to Humans - Probably carcinogenic to humans [on line]. Dostupný na WWW:
http://monographs.iarc.fr/ENG/Classification/crthgr02a.php
8. Sessink, P.J., Bos, R.P. Drugs hazardous to healthcare workers - evaluation of methods for monitoring occupational exposure to cytostatic drugs. Drug. Saf., 1999, 20(4), p. 347-359.
9. Sessink, P.J., Cerná, M., Rössner, P. et al. Urinary cyclophosphamide excretion and chromosomal aberrations in peripheral blood lymphocytes after occupational exposure to antineoplastic agents. Mutat. Res. 1994, 309(2), p. 193-199.
10. Skov, T., Lynge, E., Maarup, B. et al. Risk for physicians handling antineoplastic drugs. Lancet 1990, 336, p. 1446.
11. Skov T., Maarup B., Olsen J. et al. Leukemia and reproductive outcome among nurses handling antineoplastic drugs. Br. J. Ind. Med. 1992, 49, p. 855-861.
12. Sorsa, M., Anderson, D. Monitoring of occupational exposure to cytostatic anticancer agents. Mut. Res. 1996, 355(1-2), p. 253-261.
13. Spruance, S.L., Reid, J.E, Grace, M., Samore, M. Hazard ratio in clinical trials. Antimicrob. Agents Chemother. 2004, 48, 8, p. 2787-2792.
14. Stucker, I., Caillard, J.F., Collin, R. et al. Risk of spontaneous-abortion among nurses handling antineoplastic drugs. Scand. J. Work Environ. Health 1990, 16(2), p. 102-107.
15. Šmerhovský, Z., Landa, K., Vavřinová, J. Registr profesionálních expozic karcinogenům (REGEX), Praha: SZÚ, 2006.
16. Undeğer, U., Başaran, N., Kars, A., Güç, D. Assessment of DNA damage in nurses handling antineoplastic drugs by the alkaline COMET assay. Mutat. Res. 1999, 439(2), p. 277-285.
17. Valanis, B., Vollmer, W.M., Steele, P. Occupational exposure to antineoplastic agents: Self-reported miscarriage and stillbirth among nurses and pharmacists. J. Occup. Environ. Med. 1999, 41(8), p. 632-638.
18. Vyhláška č. 432/2003 Sb. [on line]. Dostupná na WWW: www.khshk.cz/odd/432-2003.doc
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2009 Issue 6
Most read in this issue
- Health problems related to drug abuse, possibility of prevention in primary care
- Painful foot
- Errors in the treatment of delirium tremens
- Syndrome of combined pulmonary fibrosis and emphysema – CPFE syndrome