Occupational exposures among nurses and risk of spontaneous abortion

Abstract

Objective-We investigated self-reported occupational exposure to antineoplastic drugs, anesthetic gases, antiviral drugs, sterilizing agents (disinfectants), and X-rays and the risk of spontaneous abortion in U.S. nurses.Study Design-Pregnancy outcome and occupational exposures were collected retrospectively from 8,461 participants of the Nurses' Health Study II. Of these, 7,482 were eligible for analysis using logistic regression.Results-Participants reported 6,707 live births, and 775 (10%) spontaneous abortions (<20 weeks). After adjusting for age, parity, shift work, and hours worked, antineoplastic drug exposure was associated with a 2-fold increased risk of spontaneous abortion, particularly with early spontaneous abortion before the 12 th week, and 3.5-fold increased risk among nulliparous women. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Exposure to sterilizing agents was associated with a 2-fold increased risk of late spontaneous abortion (12-20 weeks), but not with early spontaneous abortion. HHS Public AccessConclusion-This study suggests that certain occupational exposures common to nurses are related to risks of spontaneous abortion.

Reproductive Health Risks Associated With Occupational Exposures to Antineoplastic Drugs in Health Care Settings

“…The studies of miscarriage had mixed results, and three of these studies were limited by small sample sizes (fewer than 20 exposed cases). The three largest studies 74–76 showed increased occurrence of miscarriages among women who reported handling of antineoplastic drugs during the first trimester. Most exposures were among oncology nurses or pharmacists.…”

Miscarriage Among Flight Attendants

“…Evidence from atomic bomb survivor studies suggested a 50 mGy threshold for adverse reproductive outcomes in humans 25 ; however, lower x-ray exposures have been associated with miscarriage in nurses (1 or more hours a day self-reported exposure) 26 and veterinarians (more than 5 self-reported films/week). 27 Flight attendants’ prepregnancy exposure rates were also low compared with the 50 mGy threshold, but generally higher than during their first trimester; half had estimated annual doses between 0.7 and 2.0 mGy (effective dose = 1.8–5.8 mSv) prior to pregnancy.…”

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

“…(7,8) Reproductive studies of female health care workers exposed to these drugs have shown infertility, miscarriage, birth defects, and other adverse pregnancy outcomes. (9,10) Oncology nurses exposed to chemotherapeutic drugs have increased risk of leukemia and other cancers. (10) An increased frequency of genotoxicity biomarkers including chromosomal aberrations were reported in health care workers who handle chemotherapy drugs.…”