Chemical Safety and Health Conditions among Hungarian Hospital Nurses

Tompa, Anna; Jakab, Mátyás G.; Bíró, Anna; Magyar, B.; Fodor, Zoltán; Klupp, Tibor; Major, Jenő

doi:10.1196/annals.1371.054

Cited by 24 publications

(17 citation statements)

References 30 publications

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“…Indeed, accounts have been reported of various symptoms experienced by nurses handling chemotherapy, such as hair loss, irregular menstrual cycle, skin and eye irritation [37][38][39]. In a previous paper we have shown increased incidence of raised blood glucose level, anemia, thyroid alterations, myoma and other benign tumors in the cytostatic drug exposed nurses [15]. Interindividual variability of immune parameters is high in human populations, so a change in a single immune test in an individual may not indicate increased susceptibility for disease [40].…”

Section: Discussionmentioning

confidence: 96%

“…We have shown that chemical exposure can alter the ratio of lymphocyte subpopulations and may cause changes in the activation of lymphocytes among oil-industry, health-service and metallurgy workers [13,14] and thus specific immunological markers can be used to assess exposure. In a previous study our research group compared geno-and immunotoxicological effect markers among nurses exposed to cytostatics [15]. The genotoxicologically affected (chromosome aberration frequency > 4% and sister chromatid exchange frequency >7.5 per mitosis) subjects showed an increase in the frequency of helper T lymphocytes (Th), activated (IL-2R positive) T and Th-cells, and transferrin receptor positive B cells compared to genotoxically non-affected subjects.…”

Section: Introductionmentioning

confidence: 98%

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Immunotoxicity Monitoring of Hospital Staff Occupationally Exposed to Cytostatic Drugs

Bíró¹,

Fodor²,

Major³

et al. 2010

Pathol. Oncol. Res.

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The aim of our study was to investigate the immunotoxicity of occupational cytostatic drug exposure, and to assess the possible effect of confounding factors, such as age and smoking. In this human study, the immunotoxic effect of antineoplastic drugs was investigated among 306 nurses working in oncology chemotherapy units. Results were compared to 98 non-exposed women. The immune status of the subjects was characterized by immune phenotyping of peripheral blood lymphocytes by flow cytometry, using monoclonal antibodies against surface antigens (CD3, CD4, CD8, CD19, CD25, CD45, CD56 and CD71). The killing ability of neutrophil leukocytes was assessed by the measurement of reactive oxygen intermediate production. Occupational exposure to antineoplastic drugs caused shifts in the major lymphocyte subpopulations, resulting in a statistically significant increase in the ratio of B cells. Cytostatic drug exposure also manifested itself in a decreased frequency of CD25 positive, activated T lymphocytes, and increased oxidative burst of neutrophil granulocytes, both of which may have a functional impact on the immune system of exposed subjects. In the younger subjects exposure also caused a shift in T cell subpopulations: a reduction in the cytotoxic T cell population lead to an elevated Th/Tc ratio. In the exposed group, smoking increased activation of T lymphocyte subpopulations. In conclusion, we have demonstrated that low dose occupational cytostatic drug exposure is immunotoxic, and age and smoking modify the effect of exposure.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 98%

Immunotoxicity Monitoring of Hospital Staff Occupationally Exposed to Cytostatic Drugs

Bíró¹,

Fodor²,

Major³

et al. 2010

Pathol. Oncol. Res.

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“…Leaks caused by poorly maintained distribution lines allow these gases to be released, where workers in central supply may inhale them. It is important to acknowledge that not only is ethylene oxide a carcinogen, neurotoxin, reproductive health hazard, and also linked with eye damage, but it is also extremely fl ammable (Steenland, Whelan, Deddens, Stayner, & Ward, 2003;Tompa et al, 2006).…”

Section: Chemical Hazardsmentioning

confidence: 99%

The Health Care Work Environment and Adverse Health and Safety Consequences for Nurses

Geiger-Brown¹,

Lipscomb²

2010

Annu Rev Nurs Res

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Nurses' working conditions are inextricably linked to the quality of care that is provided to patients and patients' safety. These same working conditions are associated with health and safety outcomes for nurses and other health care providers. This chapter describes aspects of the nursing work environment that have been linked to hazards and adverse exposures for nurses, as well as the most common health and safety outcomes of nursing work. We include studies from 2000 to the present by nurse researchers, studies of nurses as subjects, and studies of workers under similar working conditions that could translate to nurses' work environment. We explore a number of work organization factors including shift work and extended work hours, safety climate and culture, teamwork, and communication. We also describe environmental hazards, including chemical hazards (e.g., waste anesthetics, hazardous drugs, cleaning compounds) and airborne and bloodborne pathogen exposure. Nurses' health and safety outcomes include physical (e.g., musculoskeletal disorders, gastrointestinal, slips, trips and falls, physical assault) and psychosocial outcomes (e.g., burnout, work-family conflict). Finally, we present recommendations for future research to further protect nurses and all health care workers from a range of hazardous working conditions.

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“…In a previous study, we have found an increase in immune alterations in hospital staff exposed to cytostatics, formaldehyde and anesthetics compared to the unexposed controls. In anesthetic-gas-exposed nurses, the use of protective measures resulted in the decrease of immune alterations [20].…”

Section: Discussionmentioning

confidence: 99%

Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

Bíró¹,

Tompa²

2013

Clin Exp Pharmacol

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In this study, changes in the immune phenotype of 127 subjects exposed to anesthetic gases from health services were measured by flow cytometry. The data was compared to healthy, non-exposed controls. We supposed that there is a relationship between health risk for the personnel exposed to anesthetic gases and the alteration of the measured immune parameters in the presence or absence of confounding factors such as smoking and alcohol consumption. In the group of health personnel exposed to anesthetic gases, we found a statistically significant increase in the ratio of CD25+/CD8+ cells -activated cytotoxic T cells -compared to the control. In those workplaces, where protective measures were strictly adhered to (with quality assurance) the activation of lymphocytes was at control level, however, where there was no quality assurance, activation of lymphocytes increased significantly compared to the control. In the anesthetic gas exposed smokers, there was a statistically significant shift in the T cell subpopulations: the percentage of helper T cells increased, while the percentage of cytotoxic T cell decreased, leading to an elevated Th/ Tc ratio compared to the nonsmokers. Our results suggest that our biomarkers can be useful in tracking occupational/ environmental immunotoxic effects. Smoking as a confounding factor has to be taken into account when assessing occupational exposures.

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Chemical Safety and Health Conditions among Hungarian Hospital Nurses

Cited by 24 publications

References 30 publications

Immunotoxicity Monitoring of Hospital Staff Occupationally Exposed to Cytostatic Drugs

Immunotoxicity Monitoring of Hospital Staff Occupationally Exposed to Cytostatic Drugs

The Health Care Work Environment and Adverse Health and Safety Consequences for Nurses

Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

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