| Objective:To evaluate the effect of antineoplastic drugs on immune function of nurses exposed to antineoplastic drugs by detecting peripheral blood lymphocyte subsets and blood routine monitoring data.At the same time,the correlation between ADs exposure years,protection level and the use of personal protective equipment and the immune function index level of nurses was analyzed to explore the possible risk factors in the occupational environment,so as to provide atheoretical basis for the formulation of effective protective measures to reduce the risk of occupational exposure and improve the occupational environment,as well as the decision-making of bringing the occupational contact population of ADs into the key monitoring objects of occupational diseases.Methods:A total of 181 nurses with at least one year of occupational exposure to ADs in3 public hospitals in Shenzhen were selected as the exposure group,and 181 nurses with no history of ADs exposure were selected as the non-exposure group.Use questionnaires to obtain general information of the research subjects,their exposure to ADs at work,daily work and risk perceptions of occupational exposure to ADs,the use of personal safety protection equipment,and health self-evaluation symptoms.2m L of fasting peripheral elbow venous blood samples were collected from the exposed group and non exposed group respectively.T lymphocyte,B lymphocyte and NK cell subsets were detected by flow cytometry.Combined with blood routine monitoring data,the effect of ADs exposure on nurses’immune function was evaluated.SPSS 21.0 statistical software was used to process the related research data.Two independent samples t-test or ANOVA was used for continuous variables.Classification data were analyzed by chi-square test.Single factor and multiple linear regression analysis were used to analyze the influencing factors of immune function indicators.Partial correlation analysis was used to analyze the relationship between lymphocyte subsets and the exposure years of ADs.All data were analyzed by two-sided test,P<0.05 was considered statistically significant.Results:(1)There were 181 people in the exposure group,aged 20-53 years,with an average age of 28.93±5.72 years;181 people in the non exposure group,aged 20-55 years,with an average age of 30.23±6.93 years.There were no significant differences in age,BMI,passive smoking and other general information between the two groups(P>0.05).(2)The results of the questionnaire showed that nurses in oncology related departments had more hair loss,menstrual disorders,stomatitis and oral ulcer,skin problems,constipation,persistent headache,burning sensation in eyes,persistent nausea or vomiting and other health self-rated symptoms after occupational exposure to ADs.(3)There was no significant difference between the exposure group and the non exposure group(P>0.05);Multivariate analysis showed that after excluding age,BMI,passive smoking and other confounding factors,no significant effect of occupational exposure to ADs on blood routine results was found(P>0.05).(4)The results of lymphocyte subsets showed that the percentage of CD3~+T cells in the exposed group was significantly lower than that in the non exposed group,and the percentage of CD16~+CD56~+NK cells in the exposed group was significantly higher than that in the non exposed group(P<0.05).The results of multivariate analysis showed that after excluding age,BMI,passive smoking and other confounding factors,the percentage of CD3~+T cells and CD16~+CD56~+NK cells were significantly affected by occupational exposure to ADs(P<0.05).(5)The percentages of CD3~+T cells,CD8~+T cells and CD16~+CD56~+NK cells of nurses in hospitals with different protection levels are significantly different(P<0.05).(6)The percentages of CD3~+T cells and CD8~+T cells of non-oncology specialist nurses were significantly lower than those of oncology specialist nurses,and the CD16~+CD56~+NK cell percentage and CD4~+/CD8~+ratio of non-oncology specialist nurses were significantly higher than those of oncology specialist nurses,the difference was statistically significant.(P<0.05).(7)The percentages of CD3~+T cells and CD16~+CD56~+NK cells of nurses with different ADs exposure years are significantly different(P<0.05).The correlation analysis results show that there is a correlation between the percentage of CD16~+CD56~+NK cells and ADs exposure years(r=0.163,P<0.05).(8)Whether wearing protective clothing according to the specification had significant difference on the percentage of CD16~+CD56~+NK cells(P<0.05).Conclusion:(1)Occupational exposure to ADs potentially affects the level of immune function of nurses,and may be related to the length of exposure to ADs.(2)By strengthen-ing the equipment of hospital protection hardware facilities,improving personal protection awareness and occupational protection compliance,it may play a protective role in reducing the occupational exposure risk of ADs,which is beneficial to provide a theoretical basis for further interventional research.(3)T,B,NK lymphocyte subsets have a certain reference value for the evaluation of occupational exposure immune function.It can be considered as one of the biological effect markers to evaluate the occupational exposure damage of ADs,and it can be included in the scope of occupational disease physical examination,and the key population should be monitored regularly. |
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