Congress Abstracts 2005

13

CHEMOTHERAPY HANDLING AND EFFECTS AMONG NURSES AND THEIR OFFSPRING. Susan Martin, RN, DNSc, AOCN^®, Oncology Nursing Consultant, Long Beach, NY.

The use of antineoplastic chemotherapeutic agents for the treatment of cancer and some other non-neoplastic diseases has expanded widely during the past several decades. There is growing concern regarding the safety of healthcare workers who handle these agents. The literature has described adverse health effects such as chromosomal aberrations, reproductive dysfunction, and acute symptomatology. At present, the literature is lacking research that investigates the occupational exposure to chemotherapy and potential adverse effects among nurses’ offspring.

This investigatation studied whether there was an association between maternal occupational antineoplastic chemotherapeutic exposure and learning disabilities among offspring as well as infertility, miscarriage and pregnancy and birth complications among oncology nurses.

The conceptual framework of the epidemiologic triad where adverse health effects is a product of an interaction between the person at risk (host), an exposure to antineoplastic chemotherapeutic (agent), and the environment (availability of resources).

This epidemiological retrospective survey case-control design surveyed 7500 members of the Oncology Nursing Society using a self-report mailed survey.

Non-parametric testing (Chi square) was used to estimate the prevalence of dependent variables. Logistic regression was used to compare prevalence of the dependent variables, adjusting for the effects of interactions, confounders or other risk factors.

The response rate was 50%. Controlling for risk factors, significant associations were reported with chemotherapy handling and infertility in nurses who handled chemotherapy before the age of 25 (OR = 1.42, 95% CI = 1.05–1.91), and miscarriages (OR = 1.01, 95% CI = 1.001–1.02). Preterm labor was associated with administering nine or greater doses of chemotherapy per day (OR = 2.98, 95% CI = 1.75–5.04) and preterm births were associated with preparing nine or greater doses per day (OR = 5.56, 95% CI = 1.96–15.78). Learning disabilities were associated with the frequency of glove use (OR = 2.56, 95% CI = 1.75–3.72). Specific learning disabilities including motor (OR = 2.53, 95% CI = 1.30–4.91), cognitive (OR = 2.25, 95% CI = 1.22–4.17), ADHD (OR = 1.88, 95% CI = 1.07–3.30), and speech (OR = 2.47, 95% CI = 1.58–3.85) were significant. These findings raise many questions regarding the potential long-term effects of chemotherapy handling on both oncology nurses and their offspring.

Funding Sources: Oncology Nursing Foundation AMGEN (Funded Doctoral Fellowship)