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BackgroundAlthough the therapeutic effect of antineoplastic drugs is incontestable, these agents can also potentially act as carcinogens, mutagens and/or teratogens in people. The aim of this study was to assess the effect of occupational exposure to antineoplastic drugs on DNA damage, assessed by the comet assay and cytokinesis-block micronucleus (CBMN) assay, in nurses.MethodsThe cross-sectional study enrolled 305 nursing staff members from 7 public hospitals in Shenzhen who handled antineoplastic drugs, and 150 healthy nursing staff members who were not exposed to antineoplastic drugs as the control group. DNA damage was assessed by the comet and CBMN assay. Multiple linear regressions and logistic regressions models were used to analyse the effect of occupational exposure to antineoplastic drugs on DNA damage.ResultsAfter adjustment for confounding factors, compared with non-exposure to antineoplastic drugs, exposure to antineoplastic drugs was positively related to tail moment, olive moment, tail length and tail DNA per cent, and adjusted β or OR (95% CI) was 0.17 (0.08 to 0.26), 0.18 (0.10 to 0.27), 1.03 (0.47 to 1.60) and 1.16 (1.04 to 1.29) (all p<0.05). Moreover, similar significant relationships were observed for the biomarkers of the CBMN assay. Additionally, other than age, there was no interaction between antineoplastic drug exposure and other variables for the levels of biomarkers of the CBMN assay and the comet assay.ConclusionsThe present results showed that exposure to antineoplastic drugs was positively related to the risk of DNA damage in nurses. The results imply that occupational exposure to antineoplastic agents is an important global public health problem that requires urgent attention.

Objective. This study intended to analyze hazardous factors of venous thrombosis by comparing the effect of different doses of heparin sodium injection on the incidence rate of peripherally inserted central catheter (PICC)-related venous thrombosis in non-small cell lung carcinoma (NSCLC) patients during postoperative chemotherapy. Methods. 425 NSCLC patients who received PICC catheterization in Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital from July 2019 to July 2021 were collected. Based on their different pathological types, patients were given two different chemotherapy regimens: pemetrexed+cisplatin or paclitaxel+cisplatin. Patients were grouped according to the different doses of heparin sodium injection adopted. Control group ( n = 140 ). Catheters were sealed with 10 mL saline only. Group I ( n = 142 ). In addition to routine maintenance with normal saline, 2 mL of 10 IU/mL heparin sodium injection was sealed in the catheters under positive pressure every time after catheterization. Group II ( n = 143 ). In addition to routine maintenance with normal saline, 5 mL of 10 IU/mL heparin sodium injection was sealed in the same manner as Group I. The baseline characteristics of the three groups of patients were compared by statistical means. Doppler ultrasonography was applied to check the venous thrombosis. The hazardous factors of venous thrombosis were analyzed through correlation analysis and binary logistic regression method. Results. The incidence rates of thrombosis in the control group, Group I, and Group II were 20.00%, 7.04%, and 2.09%, respectively, with statistically significant differences ( P < 0.01 ). Additionally, through the collinear correlation analysis of baseline characteristics, a significant correlation between the dosage of heparin sodium injection and the incidence of thrombosis was observed ( P < 0.05 ), but there were no significant differences between other baseline data and the incidence of thrombosis ( P > 0.05 ). Binary logistic regression analysis revealed that postoperative use of heparin sodium injection (Group I: OR = 0.312 ; P = 0.003 ; Group II: OR = 0.082 , P < 0.001 ) was a protective factor for preventing thrombosis. In addition, the thromboprophylaxis effect of Group II was better than that of Group I. No serious adverse reactions were found in safety analysis. Conclusion. Heparin sodium could significantly lower the incidence rate of PICC-related venous thrombosis in NSCLC patients during postoperative chemotherapy. Heparin sodium injection is safe enough to be promoted among PICC patients with a high risk of venous thrombosis.

Objective To explore the relationships between Chinese nurses’ knowledge, perceptions, and attitudes and their behavior and actual implementation of safety measures when handling antineoplastic drugs (ADs) in their daily work. Methods This was a multisite study conducted in 8 public hospitals in China. A self-administered questionnaire was sent to participants querying the degree of contact with ADs. The hypothesized relations were explored using structural equation modelling via the bootstrap method. Mediation analysis was applied to explore the mediating role of protective knowledge regarding AD exposure on the associations among protective training, using warning labels, and using protective masks. Results A total of 305 nurses were enrolled. The average age of all participants was 30.2 (standard deviation [SD]: 6.2) years. Nurses who had received protective training for AD exposure were more likely to use labels for ADs after age, body mass index (BMI), length of service, marital status, education, and department were controlled as covariates. The bias-corrected bootstrap of 95% confidence interval (CI) indicated that protective knowledge significantly mediated (23.4%) the association between protective training and using labels (indirect effect = 0.202, 95% CI: 0.009, 0.495); the proportion of mediation was 23.4%. Protective knowledge significantly mediated the association between protective training and using protective masks (indirect effect = 0.157, 95% CI: 0.048, 0.325); the proportion of mediation was 27.2%. Conclusions The findings of this study have provided baseline information on the current state of Chinese nurses’ perceptions, knowledge, and preventive behaviors toward ADs as the crisis is happening. Training is also recommended to improve nurses’ perceptions of the risks associated with ADs.